Prescribing Patterns and Treatment Adherence in Patients with Asthma During the COVID-19 Pandemic

TY - JOUR

T1 - Prescribing Patterns and Treatment Adherence in Patients with Asthma During the COVID-19 Pandemic

AU - Dhruve, Hetal

AU - d'Ancona, Grainne

AU - Holmes, Steven

AU - Dhariwal, Jaideep

AU - Nanzer, Alexandra M.

AU - Jackson, David J.

N1 - Funding Information: H. Dhruve contributed to study design, data collection, analysis, and manuscript preparation. D. J. Jackson, G. d'Ancona, A. M. Nanzer, J. Dhariwal, and S. Holmes contributed to data analysis and manuscript preparation. No funding was received for this work. Publisher Copyright: © 2021 American Academy of Allergy, Asthma & Immunology Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2022/1

Y1 - 2022/1

N2 - Background: The COVID-19 pandemic has witnessed a reduction in asthma exacerbations across the United Kingdom. Several factors may underpin this, including reduced transmission of seasonal viruses and improved adherence to inhaled corticosteroids (ICS). However, little is known about how ICS use has changed during the pandemic. Objective: To identify prescribing patterns for asthmatics during the pandemic. Methods: Using the OpenPrescribing database, we retrospectively analyzed prescribing patterns of ICS, salbutamol and peak flow meters from January 2019 to January 2021 across England. In addition, using a sample asthma cohort at 3 primary care practices in London, we assessed individual prescription patterns. Results: A sharp increase in national ICS prescriptions occurred in March 2020 representing a 49.9% increase compared with February 2020. The sample cohort included 1132 patients (762 ICS treated across both years). Overall ICS adherence improved in 2020 (P < .001), with the proportion of patients meeting “good adherence” (≥75%) increasing from 33.9% to 42.0% (P < .001). The March 2020 spike predominantly reflected improved adherence rather than a hoarding effect of multiple inhalers. Female gender and increasing age were associated with the most significant improvements in adherence. A similar spike in salbutamol occurred in March 2020; however, an overall reduction in salbutamol prescriptions occurred in 2020 (P = .039). National figures highlighted a progressive increase in prescription of peak flow meters over 2020. Conclusion: ICS adherence rates remain low; however, a modest improvement in adherence was observed during the first year of the COVID-19 pandemic. Salbutamol prescription rates reduced over the same time period, whereas prescriptions for peak flow meters have steadily increased.

AB - Background: The COVID-19 pandemic has witnessed a reduction in asthma exacerbations across the United Kingdom. Several factors may underpin this, including reduced transmission of seasonal viruses and improved adherence to inhaled corticosteroids (ICS). However, little is known about how ICS use has changed during the pandemic. Objective: To identify prescribing patterns for asthmatics during the pandemic. Methods: Using the OpenPrescribing database, we retrospectively analyzed prescribing patterns of ICS, salbutamol and peak flow meters from January 2019 to January 2021 across England. In addition, using a sample asthma cohort at 3 primary care practices in London, we assessed individual prescription patterns. Results: A sharp increase in national ICS prescriptions occurred in March 2020 representing a 49.9% increase compared with February 2020. The sample cohort included 1132 patients (762 ICS treated across both years). Overall ICS adherence improved in 2020 (P < .001), with the proportion of patients meeting “good adherence” (≥75%) increasing from 33.9% to 42.0% (P < .001). The March 2020 spike predominantly reflected improved adherence rather than a hoarding effect of multiple inhalers. Female gender and increasing age were associated with the most significant improvements in adherence. A similar spike in salbutamol occurred in March 2020; however, an overall reduction in salbutamol prescriptions occurred in 2020 (P = .039). National figures highlighted a progressive increase in prescription of peak flow meters over 2020. Conclusion: ICS adherence rates remain low; however, a modest improvement in adherence was observed during the first year of the COVID-19 pandemic. Salbutamol prescription rates reduced over the same time period, whereas prescriptions for peak flow meters have steadily increased.

KW - Adherence

KW - Asthma

KW - COVID-19

KW - Inhaler devices

UR - http://www.scopus.com/inward/record.url?scp=85116873089&partnerID=8YFLogxK

U2 - 10.1016/j.jaip.2021.09.032

DO - 10.1016/j.jaip.2021.09.032

M3 - Article

AN - SCOPUS:85116873089

SN - 2213-2198

VL - 10

SP - 100-107.e2

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

IS - 1

ER -