Impact of COVID-19 pandemic on medication use in the older Italian population

Abstract

Objective This study aims to analyse the impact of the pandemic on the amount of use and new medication dispensation for chronic diseases in the Italian population aged 65 years and older (almost 14 million inhabitants). Methods The “Pharmaceutical Prescriptions database”, which gathers data on medications, reimbursed by the National Health Service and dispensed by community pharmacies, was employed. Data were analysed as amount of use (defined daily dose—DDD per 1000 inhabitants); variation in DDD between 2020 and 2019 was calculated for the 30 categories with major consumption in 2020. Trends in prevalence and incidence of dispensations between 2020 and 2019 were calculated for four categories: antidiabetics, antihypertensives, antidepressants and drugs for respiratory diseases. Results All medications showed a negative variation in DDD/1000 inhabitants between 2020 and 2019 except for anticoagulants (+ 5%). The percentage variation ranged from − 27.7% for antibiotics to − 6.4% for antipsychotics in 85 + year-old persons, but increased for most classes in the youngest (65–69 years). On the other hand, a decrease of the dispensation incidence of antidiabetics, antihypertensives, antidepressants and drugs for pulmonary disease was high, especially in the two extreme age groups, the youngest and the oldest one. Conclusions and relevance Great variation in medication use between 2020 and 2019 was observed probably reflecting the low rate of infectious diseases due to the widespread use of protective devices and self-isolation, reduced healthcare access because of the lockdowns and the fear of going to hospital, and the reduction of screening and diagnostics due to health-care system overload.

Impact of COVID-19 on patterns of drug utilization: A case study at national hospital

“…Consequently, based on outpatients followed up for long periods, it is anticipated that there might be deterioration in the cardiovascular conditions or the appearance of additional cardiovascular diseases, taking the increases in the consumption of cardiovascular drugs into consideration. A study on older Italian population by Marengoni et al showed that the percentage of drugs active on the cardiovascular system use fluctuated in all elderly population aged sub-groups ranging from -21.2 to 3.6% in COVID-19 period compared to pre-pandemic period with an increase observed in 65-69 aged, while there were positive changes in the consumption of antihypertensives during COVID-19 pandemic in 65-69 aged group and 75-79 aged group, with an increase by 2.4% and 0.7%, respectively [15]. In contrast, the drug use of outpatients with Medicaid by Elizabeth Williams experienced a decrease of 3% in the drug utilization of cardiac drugs in COVID-19 period (2020) compared to the pre-COVID-19 period (2019) [34].…”

“…COVID-19 has disrupted both individual visits and access to medical prescriptions from outpatient services at hospitals, which caused many disadvantages in regards to worsen symptoms of chronic diseases [4,[12][13][14]. Several studies have examined the impact of COVID-19-related restrictions on drug utilization among outpatients, revealing fluctuations in the prescription patterns for chronic conditions [15][16][17]. However, there is a limited body of research focusing on the elderly population, who require special attention due to their high prevalence of chronic diseases and comorbidities, making them particularly vulnerable to the effects of the pandemic [18][19][20].…”

Paracetamol: should we hide it within the NSAID category to dismiss its real infodemiology analysis?

“…This evaluation completely disappeared in the herein commented paper [ 1 ]. The authors never mentioned paracetamol, which probably included in the more general NSAIDs terminology.…”

“…I read with interest the recent contribution by Marengoni et al, on this journal, where the authors investigated the impact of SARS-CoV2 pandemic on the consumption of pharmaceuticals in the Italian elderly population (almost 14 million inhabitants) [ 1 ]. Contrarily to other infodemiological surveys, some of which conducted in our University Department [ 2 ], the authors reported a reduction in the delta% of DDD/1,000 inhabitants for the period 2019–2020 of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), probably grounding their statement on the most recent AIFA and OSMED reports, as co-authors of these latter ones [ 1 ].…”

“…The authors reported a decrease in the use of NSAIDs in 2020 respect to 2019, by 13% [ 1 ]. On 1,801 samples investigated in 2019, there was no variation in drug exposure between hospital entry and hospital discharge for NSAIDs and + 2.7% for paracetamol [ 3 ], whereas the data for NSAIDs reported a decrease of more than 25% in the use DDD/1,000 inhabitants passing from 2019 to 2020 [ 1 ].…”