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. 2023 May 15:14:1129244.
doi: 10.3389/fphar.2023.1129244. eCollection 2023.

Impact of COVID-19 epidemic on antihypertensive drug treatment disruptions: results from a nationwide interrupted time-series analysis

Clément Mathieu  1 , Julien Bezin  1   2 , Antoine Pariente  1   2
Affiliations

Impact of COVID-19 epidemic on antihypertensive drug treatment disruptions: results from a nationwide interrupted time-series analysis

Clément Mathieu et al. Front Pharmacol. .

Abstract

Background: The COVID-19 epidemic has disrupted care and access to care in many ways. It was accompanied by an excess of cardiovascular drug treatment discontinuations. We sought to investigate a deeper potential impact of the COVID-19 epidemic on antihypertensive drug treatment disruptions by assessing whether the epidemic induced some changes in the characteristics of disruptions in terms of duration, treatment outcome, and patient characteristics. Methods: From March 2018 to February 2021, a repeated cohort analysis was performed using French national health insurance databases. The impact of the epidemic on treatment discontinuations and resumption of antihypertensive medications was assessed using preformed interrupted time series analyses either on a quarterly basis. Results: Among all adult patients on antihypertensive medication, we identified 2,318,844 (18.7%) who discontinued their antihypertensive treatment during the first blocking period in France. No differences were observed between periods in the characteristics of patients who interrupted their treatment or in the duration of treatment disruptions. The COVID-19 epidemic was not accompanied by a change in the proportion of patients who fully resumed treatment after a disruption, neither in level nor in trend/slope [change in level: 2.66 (-0.11; 5.42); change in slope: -0.67 (-1.54; 0.20)]. Results were similar for the proportion of patients who permanently discontinued treatment within 1 year of disruption [level change: -0.21 (-2.08; 1.65); slope change: 0.24 (-0.40; 0.87)]. Conclusion: This study showed that, although it led to an increase in cardiovascular drug disruptions, the COVID-19 epidemic did not change the characteristics of these. First, disruptions were not prolonged, and post-disruption treatment outcomes remained unchanged. Second, patients who experienced antihypertensive drug disruptions during the COVID-19 outbreak were essentially similar to those who experienced disruptions before it.

Keywords: COVID-19; antihypertensive drug; cardiovascular drugs; impact assessment; interrupted time series; pharmacoepidemiology; treatment disruption.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Illustration defining the concepts used to define drug treatment disruptions.
FIGURE 2
FIGURE 2
Definitions of an antihypertensive drugs disruption (A), and definition of the different outcomes for treatment after disruption (B).
FIGURE 3
FIGURE 3
Time series of the number of patients who had at least one disruption of antihypertensive drugs, per quarter (A), per week (B), and per according to antihypertensive drug categories (C), between March 2018 and December 2021, in France.
FIGURE 4
FIGURE 4
Evolution of the distribution of antihypertensive drug treatment outcomes for the disruptions observed between March 2018 and February 2021 in France (A), and evolution of the median duration before treatment resumption (B).
See this image and copyright information in PMC

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