The Impact of COVID-19 Pandemic on Drug Utilization Patterns: A Population-based Cohort Study in Manitoba, Canada

Friday, August 26, 2022

5:50 PM – 5:55 PM CEST

Location: C1M2

Publication Number: 111

Background: The COVID-19 pandemic has led the Canadian provincial governments to take unprecedented measures, including restrictions to healthcare services and pharmacists. Limited evidence exists on changes in prescription trends in Canada during the pandemic period, compared to the pre-pandemic period.

Objectives: To examine the trend of prescription medications' utilization before and during COVID-19, among incident and prevalent users in the general population. We also examined 8 major classes of medications.

Methods: We used the administrative health databases form the province of Manitoba, Canada, to conduct a province-wide cohort study. Incident and prevalent use was compared between two time periods; pre-COVID-19: July 2016 to February 2020 and during COVID-19: March 2020 to March 2021. Interrupted time series analysis using autoregressive models was used to quantify the change in level and slope in quarterly medication use among incident and prevalent users. Medications classes included anti-diabetics, cardiovascular, opioids, respiratory, antibiotics, antivirals, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs). Individuals who received at least one prescription within each quarter were considered exposed.

Results: The quarterly study population ranged from 1,353,485 to 1,411,630 Manitobans (mean age=38+23.35) and 50.18% were female. The most common comorbidities were asthma (26.67%), hypertension (20.64%), and diabetes (8.31%). The pandemic restrictions resulted in a statistically significant decline in the utilization of all medication classes captured among both incident users (percentage change of 45.55% [p=0.002]) and prevalent users (percentage change of 12.17% [p=0.005]). Subclass analysis showed a significant drop among incident users of antibiotics, cardiovascular drugs and opioids use by 46.83% (p=0.008), 23.05% (p < 0.001), and 30.98% (p= 0.002), respectively. We observed a significant slope change during COVID-19 among incident cardiovascular users (β3 = 0.0439, p=0.014) and antidiabetics (β3 = 0.0251, p=0.001) compared to the pre-COVID-19 period. However, there was no significant change in slope among NSAIDs (β3 = 0.0630, p=0.069), opioids (β3 = 0.0803, p=0.242) nor antibiotics (β3= -0.0470, p=0.911) prevalent users.

Conclusions: Our findings show a significant impact of COVID-19 on prescription trends in the general population. The observed decline among several medication classes was temporary. Further research is needed to monitor prescription trends and better understand if those changes were associated with increased health services and worsened outcomes.

Presenting Author(s)

Laila Nabil Mahmoud Helmy Aboulatta

The University of Manitoba
Winnipeg, Manitoba, Canada

Slides

Co-Author(s)

Payam Peymani, PharmD

Postdoctoral Fellow
The University of Manitoba
Winnipeg, Manitoba, Canada
Christine Vaccaro, BSc

College of Pharmacy, University of Manitoba
Winnipeg, MB, Canada
CL

Christine Leong

Assistant Professor
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Canada
KK

Kaarina Kowalec

Assistant Professor
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, MB, Canada
JD

Joseph Delaney, PhD

Associate Professor
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba
Winnipeg, MB, Canada
JF

Jamie Falk

Associate Professor
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, MB, Canada
SA

Silvia Alessi-Severini

Professor
College of Pharmacy, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Canada., MB, Canada
BA

Basma Aloud

University of Manitoba, MB, Canada
Sherif Eltonsy

The University of Manitoba
University of Manitoba
Winnipeg, Manitoba, Canada