Impact of COVID-19 pandemic on community medication dispensing: a national cohort analysis in Wales, UK

  1. Fatemeh Torabi
  2. Ashley Akbari
  3. Laura North
  4. Jane Lyons
  5. Stuart Bedston
  6. Hoda Abbasizanjani
  7. Mike Gravenor
  8. Gareth Davies
  9. Rowena Griffiths
  10. Daniel Harris
  11. Neil Jenkins
  12. Andrew Morris
  13. Julian Halcox
  14. Ronan A Lyons

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Abstract

BackgroundPopulation-level information on dispensed medication provides insight on the distribution of treated morbidities, particularly if linked to other population-scale data at an individual-level. ObjectiveTo evaluate the impact of COVID-19 on dispensing patterns of medications. MethodsRetrospective observational study using population-scale, individual-level dispensing records in Wales, UK. Total dispensed drug items for the population between 1st January 2016 and 31st December 2019 (3-years, pre-COVID-19) were compared to 2020 with follow up until 27th July 2021 (COVID-19 period). We compared trends across all years and British National Formulary (BNF) chapters and highlighted the trends in three major chapters for 2019-21: 1-Cardiovascular system (CVD); 2-Central Nervous System (CNS); 3-Immunological & Vaccine. We developed an interactive dashboard to enable monitoring of changes as the pandemic evolves. ResultAmongst all BNF chapters, 73,410,543 items were dispensed in 2020 compared to 74,121,180 items in 2019 demonstrating -0.96% relative decrease in 2020. Comparison of monthly patterns showed average difference (D) of -59,220 and average Relative Change (RC) of -0.74% between the number of dispensed items in 2020 and 2019. Maximum RC was observed in March 2020 (D= +1,224,909 and RC= +20.62%), followed by second peak in June 2020 (D= +257,920, RC= +4.50%). A third peak was observed in September 2020 (D= +264,138, RC= +4.35%). Large increases in March 2020 were observed for CVD and CNS medications across all age groups. The Immunological and Vaccine products dropped to very low levels across all age groups and all months (including the March dispensing peak). ConclusionsReconfiguration of routine clinical services during COVID-19 led to substantial changes in community pharmacy drug dispensing. This change may contribute to a long-term burden of COVID-19, raising the importance of a comprehensive and timely monitoring of changes for evaluation of the potential impact on clinical care and outcomes.

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  1. Version published to 10.23889/ijpds.v5i4.1715
  2. ScreenIT

    SciScore for 10.1101/2021.02.15.21251552: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: The patient level data used in our study are available as a monthly extract to SAIL Databank at the patient level; this provides the opportunity to use aggregated level data for monitoring trends in near real-time, as well as exploring the effect of patient-level factors such as age, sex, socioeconomic status and ethnicity. This mechanism provides the powerful opportunity to using these data not only to monitor and evaluate prescribing and dispensing trends in near real-time, but also to explore the effect of changing treatment patterns on outcomes considering a comprehensive selection of patient-level factors. Our study developed a version of the linked dispensing data which was has mapped DM+D codes to the BNF codes and chapters. This provides an opportunity to further investigate trends within each drug category, as well as wider collaboration across harmonised data sources.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.02.15.21251552v1 on medRxiv