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Observational Study
. 2022 Apr 28;5(4):1715.
doi: 10.23889/ijpds.v5i4.1715. eCollection 2020.

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

Fatemeh Torabi  1 , Ashley Akbari  1 , Stuart Bedston  1 , Gareth Davies  1 , Hoda Abbasizanjani  1 , Mike Gravenor  2 , Rowena Griffiths  1 , Daniel Harris  1 , Neil Jenkins  3 , Jane Lyons  1 , Andrew Morris  2 , Laura North  1 , Julian Halcox  1 , Ronan A Lyons  1
Affiliations
Observational Study

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

Fatemeh Torabi et al. Int J Popul Data Sci. .

Abstract

Background: Population-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.

Objective: To evaluate the impact of COVID-19 on dispensing patterns of medications.

Methods: Retrospective observational study using population-scale, individual-level dispensing records in Wales, UK. Total dispensed drug items for the population between 1 st January 2016 and 31 st December 2019 (3-years, pre-COVID-19) were compared to 2020 with follow up until 27 th 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.

Result: Amongst 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).

Conclusions: Reconfiguration 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.

Keywords: COVID-19; community dispensing; dispensed medication; interactive dispensing dashboard; public health.

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Conflict of interest statement

Statement on conflicts of interest: The author(s) declare(s) that they have no competing interests.

Figures

Figure 1: CONSORT of cohort extraction and number of matched mapped DM + D codes to BNF
Figure 1: CONSORT of cohort extraction and number of matched mapped DM + D codes to BNF
Figure 2: Total number of dispensed items per month of the year and relative changes – in 2020&2021 vs 2019
Figure 2: Total number of dispensed items per month of the year and relative changes – in 2020&2021 vs 2019
Figure 3: Number of dispensed items per BNF chapter per month – in 2020&2021 vs 2019 (numbers of each chapter are individually scaled)
Figure 3: Number of dispensed items per BNF chapter per month – in 2020&2021 vs 2019 (numbers of each chapter are individually scaled)
Figure 4: Age-standardised dispensing rates for <i>cardiovascular system</i> in per 100,000 pop’n per year and month for 2020&amp;2021 vs 2019
Figure 4: Age-standardised dispensing rates for cardiovascular system in per 100,000 pop’n per year and month for 2020&2021 vs 2019
Figure 5: Age-standardised dispensing rates for Central Nervous System in per 100,000 pop’n per year and month for 2020&2021 vs 2019
Figure 5: Age-standardised dispensing rates for Central Nervous System in per 100,000 pop’n per year and month for 2020&2021 vs 2019
Figure 6: Age-standardised dispensing rates for <i>Immunological Products &amp; Vaccines</i> in per 100,000 pop’n per year and month for 2020&amp;2021 vs 2019
Figure 6: Age-standardised dispensing rates for Immunological Products & Vaccines in per 100,000 pop’n per year and month for 2020&2021 vs 2019
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