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Siafarikas C, Karamanakos G, Makrilakis K, Tsolakidis A, Mathioudakis K, Liatis S. Prevalence and Incidence of Medication-Treated Diabetes and Pattern of Glucose-Lowering Treatment During the COVID-19 Pandemic: Real-World Data from the Electronic Greek Prescription Database. Exp Clin Endocrinol Diabetes 2024. [PMID: 38626912 DOI: 10.1055/a-2307-4631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVES This study aimed to investigate the prevalence and incidence of medication-treated diabetes mellitus and the evolving patterns of glucose-lowering treatments the year before and during the first two years of the coronavirus disease 2019 (COVID-19) pandemic. METHODS Data from the Greek electronic prescription database were analyzed for 2019, 2020, and 2021. The study population included individuals with active social security numbers. Prevalence and incidence rates were calculated based on the dispensing of glucose-lowering medications according to their unique anatomical therapeutic chemical (ATC) code. RESULTS The study population comprised 10,289,140 individuals in 2019, 10,630,726 in 2020, and 11,246,136 in 2021. Diabetes prevalence rates were 8.06%, 6.89%, and 7.91%, and incidence rates were 16.8/1000, 8.6/1000, and 13.4/1000 individuals, respectively. Metformin was the most prescribed medication, and newer classes, like sodium-glucose cotransporter-2 inhibitors 2 (SGLT-2) inhibitors and glucagon like peptide-1 (GLP-1) receptor agonists exhibited increasing trends. CONCLUSIONS The study identified a decrease in medication-prescribed diabetes prevalence and incidence during the initial year of the COVID-19 pandemic, attributed to healthcare access restrictions. Subsequently, figures returned close to baseline levels. Glucose-lowering medication trends reflected adherence to local and international guidelines, with metformin as the cornerstone, and increasing preference for newer classes such as GLP-1 receptor agonists and SGLT-2 inhibitors.
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Affiliation(s)
- C Siafarikas
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - G Karamanakos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - K Makrilakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - A Tsolakidis
- e-Government Center for Social Security Services (IDIKA), Athens, Greece
| | - K Mathioudakis
- e-Government Center for Social Security Services (IDIKA), Athens, Greece
| | - S Liatis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
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Vizdiklar C, Aydin V, Tazegul G, Kaskal M, Akici A. Use of lipid-lowering drugs in restricted health access settings: Results from the trends in drug utilization during COVID-19 pandemic in Turkey (PANDUTI-TR) study. Vascul Pharmacol 2024:107382. [PMID: 38815702 DOI: 10.1016/j.vph.2024.107382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND COVID-19 restrictions prompted changes in chronic disease management and lifestyle modifications, potentially altering cardiometabolic indicators and lipid-lowering pharmacotherapy patterns. We aimed to assess lipid-lowering drug (LLD) utilization trends during COVID-19 restrictions. METHODS We obtained nationwide outpatient drug sales and prescribing data for 01.03.2018-31.12.2022 from IQVIA™ Turkey. We evaluated average monthly LLD consumption, their costs, and quarterly prescribing levels in three periods: "before restrictions" (BfR, 01.03.2018-31.03.2020), "during restrictions" (DuR, 01.04.2020-31.03.2022), and "after restrictions" (AfR, 01.04.2022-31.12.2022). Drug utilization was measured via "defined daily dose/1000 inhabitants/day" (DID) metric. RESULTS LLD utilization increased from 25.4 ± 3.1 DID in BfR to 36.2 ± 6.8 DID in DuR (p < 0.001), and to 42.6 ± 5.3 DID in AfR (p < 0.001 vs. BfR). Statin consumption significantly rose from 22.0 ± 3.0 DID in BfR to 31.6 ± 6.3 DID in DuR (p < 0.001), and further to 37.6 ± 4.7 DID in AfR (p < 0.01 vs. DuR). High-intensity statin consumption elevated by 115.9% in AfR compared to baseline (p < 0.001). Prescribing of LLDs decreased from 12.5 ± 0.6 DID in BfR to 7.2 ± 1.2 DID in DuR (p < 0.001), later reached 13.6 ± 3.8 DID in AfR (p < 0.001 vs. DuR), with prescribing for ongoing users following similar trend. Expenditure on LLDs increased from €8.4 m ± 0.9 m in BfR to €11.4 m ± 2.0 m in DuR (p < 0.001) and to €12.8 m ± 1.9 m in AfR (p < 0.001 vs. BfR). CONCLUSIONS This study revealed a surge in consumption of LLDs in Turkey following the onset of the COVID-19 pandemic. This rise might be related to practices facilitating drug access, in addition to potentially greater adherence, or the necessity for more intense pharmacotherapy due to elevated cardiovascular risk.
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Affiliation(s)
- Caner Vizdiklar
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Volkan Aydin
- Department of Medical Pharmacology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey; Hypertension and Atherosclerosis Research Centre, Marmara University, Istanbul, Turkey
| | - Gokhan Tazegul
- Division of General Internal Medicine, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mert Kaskal
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet Akici
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey; Hypertension and Atherosclerosis Research Centre, Marmara University, Istanbul, Turkey.
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Katayama Y, Tanaka K, Domi H, Masui J, Nakao S, Tachino J, Hirose T, Kitamura T, Oda J, Matsuoka T. Outcome of emergency patients transported by ambulance during the COVID-19 pandemic in Osaka Prefecture, Japan: a population-based descriptive study. Front Public Health 2024; 11:1322236. [PMID: 38274542 PMCID: PMC10808805 DOI: 10.3389/fpubh.2023.1322236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Background The novel corona virus (COVID-19) pandemic occurred worldwide. Although an excessive burden was placed on emergency medical institutions treating urgent and severe patients, its impact on patient outcome remains unknown. This study aimed to assess the impact of the COVID-19 pandemic in 2021 on the emergency medical services (EMS) system and patient outcomes in Osaka Prefecture, Japan. Methods This was a retrospective descriptive study with a study period from January 1, 2019 to December 31, 2021. We included patients who were transported by ambulance and had cleaned data that was recorded in the ORION system. The study endpoints were the number of patients transported by ambulance and the number of deaths among these patients in each month. To assess the impact of the COVID-19 pandemic on the EMS system, the incidence rate ratio (IRR) and 95% confidence interval (CI) were calculated using 2019 as the reference year. Mortalities were evaluated based on deaths in the emergency department and deaths at 21 days after hospitalization. Results The numbers of patients transported by ambulance were 500,194 in 2019, 443,321 in 2020 (IRR: 0.88, 95% CI: 0.87-0.88), and 448,054 in 2021 (IRR: 0.90, 95% CI: 0.89-0.90). In 2019, the number of patients transported by ambulance and who died in the emergency departments was 4,980, compared to 5,485 in 2020 (IRR: 1.10, 95% CI; 1.06-1.44) and 5,925 in 2021 (IRR: 1.19, 95% CI: 1.15-1.24). In 2019, the number of patients who died within 21 days after hospitalization was 11,931, compared to 11,913 in 2020 (IRR; 1.00, 95% CI; 0.98-1.03) and 13,376 in 2021 (IRR; 1.12, 95% CI; 1.09-1.15). Conclusion The COVID-19 pandemic decreased the number of ambulance requests and worsened mortality of patients transported by ambulance in Osaka Prefecture during 2021.
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Affiliation(s)
- Yusuke Katayama
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenta Tanaka
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hisaya Domi
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Osaka Prefectural Government, Osaka, Japan
| | - Jun Masui
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Emergency Medicine, Tane General Hospital, Osaka, Japan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuhisa Kitamura
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jun Oda
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuya Matsuoka
- The Working Group to Analyze the Emergency Medical Care System in Osaka Prefecture, Osaka, Japan
- Rinku General Medical Center, Izumisano, Japan
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Yang L, Tang S, He M, Guo J, Gabriel N, Swabe G, Gellad WF, Essien UR, Saba S, Benjamin EJ, Magnani JW, Hernandez I. COVID-19 pandemic and initiation of treatment for atrial fibrillation: a nationwide analysis of claims data. BMC Cardiovasc Disord 2023; 23:604. [PMID: 38066445 PMCID: PMC10704685 DOI: 10.1186/s12872-023-03614-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic profoundly disrupted the delivery of medical care. It remains unclear whether individuals diagnosed with new onset disease during the pandemic were less likely to initiate treatments after diagnosis. We sought to evaluate changes in the treatment initiation of patients newly diagnosed with atrial fibrillation (AF) after the onset of the COVID-19 pandemic. METHODS In this retrospective cohort study, we identified individuals with incident AF from 01/01/2016-09/30/2021 using Optum's de-identified Clinformatics® Data Mart Database. The primary outcome was initiation of oral anticoagulation (OAC) within 30 days of AF diagnosis. Secondary outcomes included initiation of OAC within 180 days of diagnosis, initiation of warfarin, direct oral anticoagulants (DOACs), rhythm control medications and electrical cardioversion within 30 days of diagnosis. We constructed interrupted time series analyses to examine changes in the outcomes following the onset of the pandemic. RESULTS A total of 573,524 patients (age 73.0 ± 10.9 years) were included in the study. There were no significant changes in the initiation of OAC, DOAC, and rhythm control medications associated with the onset of the pandemic. There was a significant decrease in initiation of electrical cardioversion associated with the onset of the pandemic. The rate of electronic cardioversion within 30 days of diagnosis decreased by 4.9% per 1,000 patients after the onset of the pandemic and decreased by about 35% in April 2020, compared to April 2019, from 5.53% to 3.58%. CONCLUSION The COVID-19 pandemic did not affect the OAC initiation within 30 days of AF diagnosis but was associated with a decline in the provision of procedures for patients newly diagnosed with AF.
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Affiliation(s)
- Lanting Yang
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Shangbin Tang
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Meiqi He
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Nico Gabriel
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Gretchen Swabe
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Walid F Gellad
- Division of General Internal Medicine, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Utibe R Essien
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, Center for the Study of Healthcare Innovation, Implementation & Policy, University of California, Greater Los Angeles VA Healthcare System, Los Angeles, Los Angeles, CA, USA
| | - Samir Saba
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Emelia J Benjamin
- Department of Epidemiology, Boston University School of Public Health, Department of Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Jared W Magnani
- Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Inmaculada Hernandez
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA.
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de Germay S, Singier A, Salvo F, Pariente A. Impact of Covid-19 Vaccination on Spontaneous Pharmacovigilance Reporting in France. Drug Saf 2023; 46:1381-1389. [PMID: 37926785 DOI: 10.1007/s40264-023-01359-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION In 2021, the massive Covid-19 vaccination campaign in France was accompanied by an intensified pharmacovigilance monitoring of their potential adverse drug reactions. The importance of this reporting might have led to an important selective reporting and overloading of Pharmacovigilance Centres, delaying the recording of some reports in the national pharmacovigilance database. In this context, we aimed to evaluate the impact of the Covid-19 vaccination campaign in France and related reports on spontaneous reporting of adverse drug reactions that were not related to the Covid-19 vaccine. METHODS We performed time-series analyses considering the monthly number of adverse drug reactions reported between January 1, 2018 and April 30, 2022 using the French Pharmacovigilance database. The impact of the Covid-19 vaccination campaign on the monthly reporting not Covid-19 vaccine related was estimated using interrupted time-series. January 2021, marking the start of the campaign, was the intervention date in the models. Analyses were run globally first considering all adverse drug reaction reports, and second according to notifier type and to case seriousness. RESULTS We included 170,294 reports registered in the French Pharmacovigilance database between January 1, 2018 and April 30, 2022 that were not Covid-19 vaccine-related. Among these, 77,067 (45.3%) were serious and 146,683 (86.1%) had been reported by health care professionals. The campaign start was associated with a nearly 35.0% decrease in average monthly reporting that was not Covid-19 vaccine-related, with a significant level decrease in the monthly number of reports of -658.0 (p < 10-3) immediately after the vaccination campaign start and a subsequent slope decrease of -50.0 (p < 10-3). This decrease was mainly due to a significant level and slope decrease (level: -739.2 p < 10-3; slope: -39 [p < 10-2]) for health care professional reports. A similar level decrease was found for the monthly number of both serious and non-serious reports (-402.3, p < 10-3; and -311.9, p = 10-2, respectively). According to the ATC 1 level, the decrease in the monthly number of reports showed similar patterns for all drugs. However, a potential increase in the number of serious reports suspecting antineoplastic and immunomodulating drugs (ATC L) or drugs targeting blood was observed (ATC B). CONCLUSION Our study showed a significant impact of the Covid-19 campaign vaccination in the reporting of adverse drug reactions that were not Covid-19 vaccine-related, of roughly 35%. This leads to a loss of information regarding the monitoring of drug safety that could have impacted the system capacity to detect safety signals for drugs other than Covid-19 vaccines.
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Affiliation(s)
- Sibylle de Germay
- INSERM, BPH, U1219 Team AHead, University of Bordeaux, 33000, Bordeaux, France.
- Department of Medical Pharmacology, CHU of Bordeaux, 33000, Bordeaux, France.
| | - Allison Singier
- INSERM, BPH, U1219 Team AHead, University of Bordeaux, 33000, Bordeaux, France
| | - Francesco Salvo
- INSERM, BPH, U1219 Team AHead, University of Bordeaux, 33000, Bordeaux, France
- Department of Medical Pharmacology, CHU of Bordeaux, 33000, Bordeaux, France
| | - Antoine Pariente
- INSERM, BPH, U1219 Team AHead, University of Bordeaux, 33000, Bordeaux, France
- Department of Medical Pharmacology, CHU of Bordeaux, 33000, Bordeaux, France
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Sambourg J, Gouverneur A, Bardoulat I, Schaeverbeke T, Truchetet ME, Maravic M. Treatment patterns in patients with rheumatoid arthritis initiating a JAK inhibitor or a TNF inhibitor based on retail pharmacies drug-dispensing data. Joint Bone Spine 2023; 90:105629. [PMID: 37634873 DOI: 10.1016/j.jbspin.2023.105629] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/03/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023]
Affiliation(s)
| | | | | | | | | | - Milka Maravic
- IQVIA, General Management, Courbevoie, France; Department of Rheumatology, Lariboisière Hospital, AP-HP, Paris, France.
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Zhou G, de Vos S, Schuiling-Veninga CCM, Bos J, Oude Rengerink K, Pasmooij AMG, Mol PGM, de Bock GH, Hak E. Community Use of Repurposed Drugs Before and During COVID-19 Pandemic in the Netherlands: An Interrupted Time-Series Analysis. Clin Epidemiol 2023; 15:923-937. [PMID: 37694159 PMCID: PMC10488695 DOI: 10.2147/clep.s418069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/27/2023] [Indexed: 09/12/2023] Open
Abstract
Background Repurposing registered drugs could reduce coronavirus disease (COVID-19) burden before novel drugs are authorized. Little is known about how the pandemic and imposed restrictions changed their dispensing. We aimed to investigate the impact of COVID-19 pandemic on repurposed drugs dispensing in the Netherlands. Methods We performed interrupted time-series study using University of Groningen prescription database IADB.nl to evaluate dispensing trends of 24 repurposed drugs before (2017-February 2020) and after (March 2020-2021) the pandemic' start. Primary outcomes were monthly prevalence and incidence rates. An autoregressive integrated moving average model assessed the effect of pandemic and stringency index (measuring strictness of government's restriction policies). Results Annual number of IADB.nl population ranged from 919,697 to 952,400. Generally, dispensing of common long-term-used drugs was not significantly affected by pandemic. The prevalence of antibacterials (-4.20 users per 1000 people), antivirals (-0.04), corticosteroids (-1.29), prednisolone (-1.32), calcium channel blocker (-0.41), and diuretics (-1.29) was lower than expected after the pandemic's start, while the prevalence of ivermectin (0.07), sulfonylureas (0.15), sodium-glucose co-transporter-2 (SGLT2) inhibitor (0.17), and anticoagulants (1.95) was higher than expected. The pandemic was associated with statistically significant decreases in the incidence of antibacterials (-1.21), corticosteroids (-0.60), prednisolone (-0.64) and anticoagulants (-0.02), and increases in ivermectin (0.02), aggregated antidiabetic drugs (0.13), and SGLT2 inhibitors (0.06). These trends were positively associated with pandemic and negatively associated with stringency index. Conclusion Dispensing of most drugs was not significantly associated with pandemic and government's response. Despite some statistically significant disruptions, these were not necessarily clinically relevant due to small absolute differences observed.
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Affiliation(s)
- Guiling Zhou
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Stijn de Vos
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Catharina C M Schuiling-Veninga
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Jens Bos
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | | | | | - Peter G M Mol
- Medicines Evaluation Board, Utrecht, the Netherlands
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Eelko Hak
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, the Netherlands
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Perino J, Ramaroson H, Ong N, Bezin J, Gilleron V, Daveluy A, Tournier M. General hospital admissions in young and middle-aged people who use psychoactive substances: Impact of Covid-19 lockdowns. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104082. [PMID: 37336071 PMCID: PMC10247883 DOI: 10.1016/j.drugpo.2023.104082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/15/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUNDS The Covid-19 pandemic offered a unique opportunity to investigate trends in hospitalizations related to psychoactive substance intoxication, since the usual health burden of social use at parties and gatherings was likely to be decreased during lockdowns and curfew periods. Since young adults are the main users of psychoactive substances for experimental and recreational purposes, this study identified and compared hospitalization trends in young adults and adults over 30 years old. METHODS This national cohort study was conducted using the French hospital discharge database. An interrupted time-series analysis for the period between 2014 and 2020 was performed in two groups: young (age 18-29) and other adults (30+) to ascertain the trends in the monthly incidence of hospitalization related to psychoactive substance intoxication (opiates, cocaine, benzodiazepines, psychostimulants, alcohol and cannabis). Hospitalization characteristics during the first and second lockdown and the period between them were compared to the reference period (from 01/01/2014 to 29/02/2020). RESULTS Among 1,358,007 stays associated with psychoactive substance intoxication, 215,430 concerned young adults. Compared with adults 30+, hospitalization trends in young adults showed a greater decrease in the number of stays during lockdown, with a maximum decrease of -39% during the first lockdown (1,566 vs. 2,576; CI95%: 2,285-2,868) versus -20% (10,212 vs. 12,894; CI95%: 12,001-13,787) in the second lockdown. Presentations for alcohol intoxication decreased throughout the pandemic, particularly during the second lockdown, while admissions for benzodiazepine intoxication increased during both lockdowns. Admissions for cannabis intoxication increased throughout the entire period. CONCLUSIONS Lockdowns were associated with fewer hospitalizations related to psychoactive substance intoxication in both age groups, especially among young adults, which might reflect a decrease in social use. Recreational use might therefore be an important target for prevention and risk minimization.
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Affiliation(s)
- J Perino
- University hospital of Bordeaux, Centre d'addictovigilance de Bordeaux, Department of medical pharmacology, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux, France.
| | - H Ramaroson
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - N Ong
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - J Bezin
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux, France
| | - V Gilleron
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - A Daveluy
- University hospital of Bordeaux, Centre d'addictovigilance de Bordeaux, Department of medical pharmacology, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France
| | - M Tournier
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; Hospital Charles Perrens, Bordeaux F-33000, France
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Mathieu C, Bezin J, Pariente A. Impact of COVID-19 epidemic on antihypertensive drug treatment disruptions: results from a nationwide interrupted time-series analysis. Front Pharmacol 2023; 14:1129244. [PMID: 37256233 PMCID: PMC10225585 DOI: 10.3389/fphar.2023.1129244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Background: The COVID-19 epidemic has disrupted care and access to care in many ways. It was accompanied by an excess of cardiovascular drug treatment discontinuations. We sought to investigate a deeper potential impact of the COVID-19 epidemic on antihypertensive drug treatment disruptions by assessing whether the epidemic induced some changes in the characteristics of disruptions in terms of duration, treatment outcome, and patient characteristics. Methods: From March 2018 to February 2021, a repeated cohort analysis was performed using French national health insurance databases. The impact of the epidemic on treatment discontinuations and resumption of antihypertensive medications was assessed using preformed interrupted time series analyses either on a quarterly basis. Results: Among all adult patients on antihypertensive medication, we identified 2,318,844 (18.7%) who discontinued their antihypertensive treatment during the first blocking period in France. No differences were observed between periods in the characteristics of patients who interrupted their treatment or in the duration of treatment disruptions. The COVID-19 epidemic was not accompanied by a change in the proportion of patients who fully resumed treatment after a disruption, neither in level nor in trend/slope [change in level: 2.66 (-0.11; 5.42); change in slope: -0.67 (-1.54; 0.20)]. Results were similar for the proportion of patients who permanently discontinued treatment within 1 year of disruption [level change: -0.21 (-2.08; 1.65); slope change: 0.24 (-0.40; 0.87)]. Conclusion: This study showed that, although it led to an increase in cardiovascular drug disruptions, the COVID-19 epidemic did not change the characteristics of these. First, disruptions were not prolonged, and post-disruption treatment outcomes remained unchanged. Second, patients who experienced antihypertensive drug disruptions during the COVID-19 outbreak were essentially similar to those who experienced disruptions before it.
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Affiliation(s)
- Clément Mathieu
- Inserm, Bordeaux Population Health Research Center, Team AHeaD, UMR 1219, University Bordeaux, Bordeaux, France
| | - Julien Bezin
- Inserm, Bordeaux Population Health Research Center, Team AHeaD, UMR 1219, University Bordeaux, Bordeaux, France
- CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
| | - Antoine Pariente
- Inserm, Bordeaux Population Health Research Center, Team AHeaD, UMR 1219, University Bordeaux, Bordeaux, France
- CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
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Katayama Y, Tanaka K, Kitamura T, Dohmi H, Masui J, Hirose T, Nakao S, Tachino J, Oda J, Matsuoka T. Incidence and outcome of patients with difficulty in hospital acceptance during COVID-19 pandemic in Osaka Prefecture, Japan: A population-based descriptive study. Acute Med Surg 2023; 10:e880. [PMID: 37564634 PMCID: PMC10410119 DOI: 10.1002/ams2.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/24/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Aim The impact of the coronavirus disease (COVID-19) pandemic on the emergency medical service system in Japan has not been fully revealed. The purpose of this study was to determine the impact of the COVID-19 pandemic in 2021 on the difficulty in hospital acceptance of patients and patient outcome in Osaka Prefecture. Methods This study was a descriptive epidemiological study with a 3-year study period from January 2019 to December 2021. We included patients who were transported by ambulance and had registered in the Osaka Emergency Information Research Intelligent Operation Network (ORION) system. The primary end-point of this study was the difficulty in hospital acceptance by month, and the secondary outcome was the mortality of patients who experience difficulty in hospital acceptance in each year. Results We included 1,302,646 cases in this study. The proportion of cases with difficulty in hospital acceptance was 2.74% (12,829/468,709) in 2019, 3.74% (15,527/414,987) in 2020, and 5.09% (21,311/418,950) in 2021. The crude odds ratio for 2020 was 1.38 (95% confidence interval, 1.35-1.41) and for 2021 was 1.90 (95% confidence interval, 1.86-1.95). In 2019, 218 patients with difficulty in hospital acceptance had died by 21 days after hospitalization, whereas the number increased to 405 in 2020 and 750 in 2021. Conclusion The number of patients experiencing difficulty in hospital acceptance during the COVID-19 pandemic in Osaka Prefecture increased, and patient outcomes were worse than before the pandemic.
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Affiliation(s)
- Yusuke Katayama
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Kenta Tanaka
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tetsuhisa Kitamura
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Hisaya Dohmi
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Osaka Prefectural GovernmentOsakaJapan
| | - Jun Masui
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
- Osaka Prefectural GovernmentOsakaJapan
- Department of Emergency MedicineTane General HospitalOsakaJapan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Jun Oda
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Tetsuya Matsuoka
- The Working Group to Analyse the Emergency Medical Care System in Osaka PrefectureOsakaJapan
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11
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Maeda M, Hasegawa Y, Tsukioka R, Oishi M. [Effect of a Family Pharmacist System on Medication Adherence of Patients with Dyslipidemia during a COVID-19 Epidemic]. YAKUGAKU ZASSHI 2023; 143:765-775. [PMID: 37661442 DOI: 10.1248/yakushi.23-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The pharmacy pharmacist's function as a family pharmacist is expected to improve adherence to medication in patients suffering from chronic diseases, including dyslipidemia. This is true even in infectious disease epidemics. In this study, using anonymously processed receipt data from 700 insurance pharmacies in our group, we evaluated medication adherence in patients taking statin drugs before, during the first and second years of coronavirus disease 2019 (COVID-19) epidemic in terms of medication persistence and medication possession, and compared the results between the family pharmacist group (FP group) and non-family pharmacist group (NoFP group). The odds ratios of good medication adherence (medication persistence and medication possession) rates for the FP group relative to the NoFP group were 1.446 [95% confidence interval (CI): 1.210-1.727] in the pre-epidemic period, 1.428 (1.192-1.710) in the first year of the epidemic, and 1.270 (1.113-1.450) in the second year of the epidemic. The FP group was significantly higher in all time periods. Therefore, it is suggested that the family pharmacist function improves adherence to statins not only before but also during the COVID-19 epidemic.
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