(N) Respiratory Drugs and Antibiotics Use Before and During COVID-19 in Asthma and COPD Patients: A Quasi-Experimental Study

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall E South

Publication Number: 638

Presenting Author(s)

Laila Nabil Mahmoud Helmy Aboulatta
– PhD student, University of Manitoba, Winnipeg, Manitoba, Canada

Co-Author(s)

Emily M. Barr
– n/a, The University of Manitoba, Yuma, Arizona, United States
Christine Leong
– Assistant Professor, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Canada
Kaarina Kowalec
– Assistant Professor, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, MB, Canada
Joseph Delaney, PhD
– Associate Professor, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
Jamie Falk
– Associate Professor, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, MB, Canada
Silvia Alessi-Severini
– Professor, College of Pharmacy, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Canada., MB, Canada
Sherif Eltonsy, PhD
– Assistant Professor, University of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada

Background: Populations with asthma and chronic obstructive pulmonary disease (COPD) are advised to adhere to their respiratory medications. However, there is conflicting evidence on how the COVID-19 pandemic has impacted asthma and COPD patients.

Objectives: To investigate the trends of respiratory medications (bronchodilators and corticosteroids) and antibiotics prescriptions in asthma and COPD patients before and during COVID-19 period in Manitoba, Canada.

Methods: A quasi-experimental study using administrative health databases from Manitoba, Canada, between July 1, 2016 and March 31, 2021 was conducted. Two cohorts were created (asthma and COPD cohorts). Interrupted time series analysis using autoregressive integrated moving average (ARIMA) - with step and ramp intervention functions - was used to investigate the immediate and rebound effects in the quarterly medication use.

Results: During the study period, we examined 894,941 asthma patients and 55,654 COPD patients. Among those, 22.6% and 56.77% of COPD and asthma patients were >65 years, respectively. Moreover, 21,896 (2.45%) asthma and 1,333 (2.4%) COPD patients tested positive for COVID-19. Among asthma patients, there was a non-significant increase in the utilization of respiratory medications by 12.26% (p=0.085) immediately after the onset of the pandemic, and significant decline in the use of respiratory antibiotics by 24.19% (p < 0.001). Over the pandemic period, there was a significant rebound effect observed by 2.7% per quarter in the utilization of respiratory antibiotics (p=0.022). Among COPD patients, there was an immediate decrease in both respiratory antibiotics and medications use by 57.79% (p=0.013) and 8.26% (p=0.261), respectively. Furthermore, the pandemic period showed a non-significant rebound effect on antibiotics utilization (β= 0.9527 and p=0.0.432) among COPD patients.

Conclusion: Our findings highlight the pandemic effect on prescribing practices among COPD and asthma patients. A significant immediate decline in the use of antibiotics was observed in both populations following the first wave of pandemic restrictions. Furthermore, a significant rebound effect was shown in asthma antibiotic use. Further research is necessary to investigate if those immediate and rebound effects were detrimental to patients’ health or quality-of-life