(259) Trends in Cardiovascular Medication Prescription Before and During the COVID-19 Pandemic

Publication Number: 933

Background: Cardiovascular patients have increased risk of severe COVID-19, including admission to intensive care unit and mortality, compared with the general population. Due to the COVID-19 pandemic, some health services including prescription of medications have been disrupted or changed in several countries. Yet, it is not known whether the pandemic has affected rates of prescription of cardiovascular drugs.

Objectives: To describe the monthly trends in filled prescription of cardiovascular drug before (pre-COVID-19 era) and during the pandemic in Norway, and to estimate changes in prescription patterns following the COVID-19 pandemic among 1) the general population and 2) patients with pre-existing cardiovascular disease.

Methods: This was a population-based cohort study comprising adults (≥ 18 years old), registered as residents in Norway between 2018 to 2021. Patients with pre-existing cardiovascular disease were identified using International Classification of Diseases codes (ICD-10) and cardiovascular medications were identified using ATC codes. Defined daily dose (DDD) per month per 1,000 individuals were calculated for each study population from January 2018 to November 2020. Interrupted time series analyses using segmented autoregressive models, adjusted for seasonal correlation, were used to estimate any changes in drug prescription due to the pandemic. March 1st, 2020 was considered as the start of the pandemic (interruption) for analyses.

Results: A total of 4,060,013 adults were included, of whom 501,002 (12.3%) had pre-existing cardiovascular disease. Before the pandemic, cardiovascular drug prescription was estimated as 14,000 DDD per month/1,000 general population and 59,000 DDD per month/1,000 cardiovascular patients. There was a monthly increase in cardiovascular prescription among the general population (125 DDD per month/1,000 adults), but no significant change in baseline trend was observed for the cardiovascular population. Although cardiovascular drug prescriptions appeared to increase at the start of the pandemic, there was no significant level change of monthly DDD per person for both the general (P > 0.99) and cardiovascular population (P = 0.48), after controlling for pre-intervention trends. The post-intervention trends also did not significantly differ from the pre-intervention periods.

Conclusions: The rate of cardiovascular drug prescriptions is increasing with time in the general population. However, there was no evidence of change in drug prescription due to the COVID-19 pandemic in the general and cardiovascular patient populations.