Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model
Objectives The COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pa...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-08-01
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| Series: | Family Medicine and Community Health |
| Online Access: | https://fmch.bmj.com/content/9/3/e001143.full |
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| author | John Scott Frazer Glenn Ross Frazer |
| author_facet | John Scott Frazer Glenn Ross Frazer |
| author_sort | John Scott Frazer |
| collection | DOAJ |
| description | Objectives The COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pandemic on primary care prescribing.Design We conducted a retrospective analysis of the English Prescribing Dataset from January 2014 to November 2020, totalling 7 542 293 921 prescriptions. Data were separated into prepandemic and pandemic sets. A Holt-Winters predictive model was used to forecast individual drug prescribing based on historic trends. Observed data were compared with the forecast quantitatively and qualitatively.Setting All prescriptions signed in England and dispensed during the years 2014–2020.Participants All residents of England who received a prescription from primary care facilities during 2014–2020.Results Prescribing of numerous health-critical medications was above predicted in March 2020, including salbutamol (53.0% (99% CI (41.2% to 66.9%))), insulin aspart (26.9% (99% CI (18.5% to 36.6%))) and tacrolimus (18.6% (99% CI (8.3% to 31.1%))). Medications for end-of-life symptom control increased in April, including levomepromazine hydrochloride (94.7% (99% CI (54.6% to 163.0%))). Medications requiring face-to-face visits decreased, including the local anaesthetic bupivacaine hydrochloride (86.6% (99% CI (89.3% to 82.0%))). There was no observed change in medications relating to type 2 diabetes, hypertension or mental health conditions.Conclusions Significantly increased prescribing of several medications was observed, especially among those critical for health. A dramatic spike in end-of-life prescribing highlights the adversity faced by community practitioners during 2020. Medications involving face-to-face consultations declined, as did contraceptives, travel-related vaccines and drugs used in dementia and Parkinson’s disease. Drugs relating to type 2 diabetes, hypertension and mental health were unchanged. |
| format | Article |
| id | doaj-art-a1a5ee03fae342dd9e83e3a0262fc0d0 |
| institution | OA Journals |
| issn | 2305-6983 2009-8774 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Family Medicine and Community Health |
| spelling | doaj-art-a1a5ee03fae342dd9e83e3a0262fc0d02025-08-20T02:12:10ZengBMJ Publishing GroupFamily Medicine and Community Health2305-69832009-87742021-08-019310.1136/fmch-2021-001143Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive modelJohn Scott Frazer0Glenn Ross Frazer1Somerville College, University of Oxford, Oxford, UKSchool of Mathematics and Physics, Queen`s University Belfast, Belfast, UKObjectives The COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pandemic on primary care prescribing.Design We conducted a retrospective analysis of the English Prescribing Dataset from January 2014 to November 2020, totalling 7 542 293 921 prescriptions. Data were separated into prepandemic and pandemic sets. A Holt-Winters predictive model was used to forecast individual drug prescribing based on historic trends. Observed data were compared with the forecast quantitatively and qualitatively.Setting All prescriptions signed in England and dispensed during the years 2014–2020.Participants All residents of England who received a prescription from primary care facilities during 2014–2020.Results Prescribing of numerous health-critical medications was above predicted in March 2020, including salbutamol (53.0% (99% CI (41.2% to 66.9%))), insulin aspart (26.9% (99% CI (18.5% to 36.6%))) and tacrolimus (18.6% (99% CI (8.3% to 31.1%))). Medications for end-of-life symptom control increased in April, including levomepromazine hydrochloride (94.7% (99% CI (54.6% to 163.0%))). Medications requiring face-to-face visits decreased, including the local anaesthetic bupivacaine hydrochloride (86.6% (99% CI (89.3% to 82.0%))). There was no observed change in medications relating to type 2 diabetes, hypertension or mental health conditions.Conclusions Significantly increased prescribing of several medications was observed, especially among those critical for health. A dramatic spike in end-of-life prescribing highlights the adversity faced by community practitioners during 2020. Medications involving face-to-face consultations declined, as did contraceptives, travel-related vaccines and drugs used in dementia and Parkinson’s disease. Drugs relating to type 2 diabetes, hypertension and mental health were unchanged.https://fmch.bmj.com/content/9/3/e001143.full |
| spellingShingle | John Scott Frazer Glenn Ross Frazer Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model Family Medicine and Community Health |
| title | Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model |
| title_full | Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model |
| title_fullStr | Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model |
| title_full_unstemmed | Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model |
| title_short | Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model |
| title_sort | analysis of primary care prescription trends in england during the covid 19 pandemic compared against a predictive model |
| url | https://fmch.bmj.com/content/9/3/e001143.full |
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