Impact of COVID-19 Pandemic on the Prescription Trends of Antiseizure Medications

Background: Epilepsy is a chronic disorder affecting 50 million patients worldwide. COVID-19 pandemic restrictions have impacted the drug prescriptions of patients with some chronic diseases. There is a lack of real-world evidence on the effect of the COVID-19 pandemic on epilepsy patients, including access to antiseizure medications (ASMs).

Objectives:

Objective: This study aimed to examine the changes in ASMs prescription trends during the COVID-19 pandemic in Manitoba, Canada.

Methods: We conducted a population-based cross-sectional study using the provincial-level administrative health databases from Manitoba, Canada. The medications' quarterly dispensation rates were reported between June 1, 2016, and March 1, 2021. We calculated the quarterly prevalence and incidence of ASMs prescriptions. We used interrupted time series analysis with autoregressive models to investigate the change in level and slope pre — and during the pandemic period. We used the 2nd quarter of 2020 as the intervention point when restrictions were implemented. We examined the trends of all ASMs, old generation ASMs, and new generation ASMs utilization.

Results: We observed a significant increase in the prevalent users of new generation ASMs with a percentage change of 0.114% (P value = 0.04). We observed no significant effect on the prevalence of all ASMs prescriptions (β2 = -0.042, P value = 0.12) and old generation ASMs prescription (β 2 = 0.01, P value = 0.51). Significant trend changes were observed among the new generation ASMs prescriptions (β 3 = 0.02, P value = 0.04) prevalent users. There were no significant change in the prescriptions trend of all ASMs (β 3 = -0.01, P value = 0.16) and old generation ASMs (β 3 = -0.005, P value = 0.24).

Among incident users with new prescriptions, we observed a significant decrease in the prescriptions of all ASMs with a percentage change of -1.567% (P value = 0.01) and non-significant decrease in new generation ASMs (β 2 = -0.03, P value = 0.06) and old generation ASMs (β 2 = -0.002, P = 0.79). We observed a significant trend change in the incidence of prescriptions of all ASMs (β 3 = -0.01, P value = 0.04) and new generation ASMs (β 3 = 0.02, P value = 0.02). No significant trend change in incidence use of old generation ASMs was observed (β 3 = -0.003, P value = 0.16).

Conclusions: Our study indicated that the pandemic restrictions were associated with a small but significant immediate increase in prescriptions of new generation ASMs among prevalent users. We also observed a decline in the overall ASMs use among incident users. Further studies are needed to evaluate if those changes could be associated with an increase in healthcare use or adverse outcomes in this vulnerable group.