PDF(Pubmed)
Abstract：
BACKGROUND: The Coronavirus disease of 2019 (COVID-19) pandemic and the corresponding mitigation measures have had a discernible impact on drug utilization among outpatients. However, limited research exists on the prescription trends in the elderly population during the pandemic period in Viet Nam.
OBJECTIVE: This study aims to analyze the effects of COVID-19 on outpatient drug utilization patterns at a national geriatric hospital in Ho Chi Minh City before and after the early onset of the pandemic.
METHODS: Data was collected from the prescriptions and administration claims, encompassing the period from January 2016 to December 2022. The dataset was divided into two periods: Period 1: January 2016 to December 2020 and Period 2: January 2021 to December 2022. The drug utilization was measured using DDD/1000P (defined daily doses-DDD per 1000 prescriptions) on a monthly basis. The analysis employed interrupted time series using Autoregressive Integrated Moving Average (ARIMA) to detect changes in drug use levels and rates.
RESULTS: A total of 1,060,507 and 644,944 outpatient prescriptions from Thong Nhat Hospital were included in Period 1 and Period 2, respectively. The median age of the patients were 58 in Period 1 and 67 years old in Period 2. The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. In terms of medication utilization, cardiovascular drugs were the most frequently prescribed, followed by drugs active on the digestive and hormonal systems. The study observed significant surges in the number of prescriptions and the average number of drugs per prescription. However, there were no significant changes in the overall consumption of all drugs. Among the drug groups related to the cardiovascular system, three subgroups experienced a sudden and significant increase: cardiac therapy, beta-blocking agents, and antihypertensives, with increasing consumption levels of 1,177.73 [CI 95%: 79.29; 2,276.16], 73.32 [CI 95%: 28.18; 118.46], and 36.70 [CI 95%: 6.74; 66.66] DDD/1000P, respectively. On the other hand, there was a significant monthly decrease of -31.36 [CI 95%: -57.02; -5.70] DDD/1000P in the consumption of anti-inflammatory and antirheumatic products. Interestingly, there was a significant increase of 74.62 [CI 95%: -0.36; 149.60] DDD/1000P in the use of antigout preparations.
CONCLUSIONS: COVID-19 resulted in a sudden, non-significant increase in overall drug consumption levels among outpatients. Notably, our findings highlight significant increases in the utilization of three drug groups related to the cardiovascular system, specifically cardiac therapy, beta-blocking agents, and antihypertensives. Intriguingly, there was a statistically significant increase in the consumption of antigout preparations, despite a decline in the monthly consumption rate of non-steroidal anti-flammatory drugs (NSAIDs). Further studies in the following years are necessary to provide a more comprehensive understanding of the impact of COVID-19 on outpatient drug utilization patterns.
OBJECTIVE: This study aims to analyze the effects of COVID-19 on outpatient drug utilization patterns at a national geriatric hospital in Ho Chi Minh City before and after the early onset of the pandemic.
METHODS: Data was collected from the prescriptions and administration claims, encompassing the period from January 2016 to December 2022. The dataset was divided into two periods: Period 1: January 2016 to December 2020 and Period 2: January 2021 to December 2022. The drug utilization was measured using DDD/1000P (defined daily doses-DDD per 1000 prescriptions) on a monthly basis. The analysis employed interrupted time series using Autoregressive Integrated Moving Average (ARIMA) to detect changes in drug use levels and rates.
RESULTS: A total of 1,060,507 and 644,944 outpatient prescriptions from Thong Nhat Hospital were included in Period 1 and Period 2, respectively. The median age of the patients were 58 in Period 1 and 67 years old in Period 2. The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. In terms of medication utilization, cardiovascular drugs were the most frequently prescribed, followed by drugs active on the digestive and hormonal systems. The study observed significant surges in the number of prescriptions and the average number of drugs per prescription. However, there were no significant changes in the overall consumption of all drugs. Among the drug groups related to the cardiovascular system, three subgroups experienced a sudden and significant increase: cardiac therapy, beta-blocking agents, and antihypertensives, with increasing consumption levels of 1,177.73 [CI 95%: 79.29; 2,276.16], 73.32 [CI 95%: 28.18; 118.46], and 36.70 [CI 95%: 6.74; 66.66] DDD/1000P, respectively. On the other hand, there was a significant monthly decrease of -31.36 [CI 95%: -57.02; -5.70] DDD/1000P in the consumption of anti-inflammatory and antirheumatic products. Interestingly, there was a significant increase of 74.62 [CI 95%: -0.36; 149.60] DDD/1000P in the use of antigout preparations.
CONCLUSIONS: COVID-19 resulted in a sudden, non-significant increase in overall drug consumption levels among outpatients. Notably, our findings highlight significant increases in the utilization of three drug groups related to the cardiovascular system, specifically cardiac therapy, beta-blocking agents, and antihypertensives. Intriguingly, there was a statistically significant increase in the consumption of antigout preparations, despite a decline in the monthly consumption rate of non-steroidal anti-flammatory drugs (NSAIDs). Further studies in the following years are necessary to provide a more comprehensive understanding of the impact of COVID-19 on outpatient drug utilization patterns.
摘要：
背景：2019年冠状病毒病（COVID-19）大流行和相应的缓解措施对门诊患者的药物利用产生了明显的影响。然而,关于越南大流行期间老年人口处方趋势的研究有限。
目的：本研究旨在分析COVID-19对大流行早期发病前后胡志明市一家国家老年医院门诊药物利用模式的影响。
方法：数据来自处方和给药声明，涵盖2016年1月至2022年12月期间。数据集分为两个时期：时期1：2016年1月至2020年12月，时期2：2021年1月至2022年12月。每月使用DDD/1000P（定义的每日剂量-DDD/1000处方）测量药物利用率。该分析使用自回归综合移动平均线(ARIMA)采用中断时间序列来检测药物使用水平和比率的变化。
结果：ThongNhat医院的1,060,507和644,944个门诊处方分别包含在第1期和第2期。患者的中位年龄在1期为58岁，在2期为67岁。最常见的合并症是血脂异常，高血压,和糖尿病。在药物利用方面，心血管药物是最常见的处方，其次是对消化系统和荷尔蒙系统有活性的药物。该研究观察到处方数量和每个处方的平均药物数量显着激增。然而,所有药物的总消耗量均无显著变化.在与心血管系统相关的药物组中，三个亚组经历了突然和显著的增加：心脏治疗，β-阻断剂,和抗高血压药，随着消费水平的增加，达到1,177.73[CI95%：79.29；2,276.16]，73.32[CI95%：28.18；118.46]，和36.70[CI95%：6.74；66.66]DDD/1000P，分别。另一方面,抗炎和抗风湿产品的消费每月显著减少-31.36[CI95%:-57.02;-5.70]DDD/1000P。有趣的是,使用抗痛风制剂的DDD/1000P显著增加74.62[CI95%:-0.36;149.60]。
结论：COVID-19导致突然，门诊患者的总体药物消费水平没有显着增加。值得注意的是,我们的发现强调了与心血管系统相关的三个药物组的使用显着增加，特别是心脏治疗，β-阻断剂,和抗高血压药。有趣的是，抗痛风制剂的消费量在统计学上有了显着增加，尽管非甾体抗炎药（NSAIDs）的月消费量下降。为了更全面地了解COVID-19对门诊药物利用模式的影响，需要在接下来的几年中进行进一步的研究。
目的：本研究旨在分析COVID-19对大流行早期发病前后胡志明市一家国家老年医院门诊药物利用模式的影响。
方法：数据来自处方和给药声明，涵盖2016年1月至2022年12月期间。数据集分为两个时期：时期1：2016年1月至2020年12月，时期2：2021年1月至2022年12月。每月使用DDD/1000P（定义的每日剂量-DDD/1000处方）测量药物利用率。该分析使用自回归综合移动平均线(ARIMA)采用中断时间序列来检测药物使用水平和比率的变化。
结果：ThongNhat医院的1,060,507和644,944个门诊处方分别包含在第1期和第2期。患者的中位年龄在1期为58岁，在2期为67岁。最常见的合并症是血脂异常，高血压,和糖尿病。在药物利用方面，心血管药物是最常见的处方，其次是对消化系统和荷尔蒙系统有活性的药物。该研究观察到处方数量和每个处方的平均药物数量显着激增。然而,所有药物的总消耗量均无显著变化.在与心血管系统相关的药物组中，三个亚组经历了突然和显著的增加：心脏治疗，β-阻断剂,和抗高血压药，随着消费水平的增加，达到1,177.73[CI95%：79.29；2,276.16]，73.32[CI95%：28.18；118.46]，和36.70[CI95%：6.74；66.66]DDD/1000P，分别。另一方面,抗炎和抗风湿产品的消费每月显著减少-31.36[CI95%:-57.02;-5.70]DDD/1000P。有趣的是,使用抗痛风制剂的DDD/1000P显著增加74.62[CI95%:-0.36;149.60]。
结论：COVID-19导致突然，门诊患者的总体药物消费水平没有显着增加。值得注意的是,我们的发现强调了与心血管系统相关的三个药物组的使用显着增加，特别是心脏治疗，β-阻断剂,和抗高血压药。有趣的是，抗痛风制剂的消费量在统计学上有了显着增加，尽管非甾体抗炎药（NSAIDs）的月消费量下降。为了更全面地了解COVID-19对门诊药物利用模式的影响，需要在接下来的几年中进行进一步的研究。
