Changes in Respiratory Medication and Antibiotic Use Among Asthma and COPD Individuals During the Pandemic
Author(s)
Laila Aboulatta, PharmD1, Payam Peymani, PhD2, Lara Haidar, PhD, PharmD2, Qier Tan, PhD2, Sherif Eltonsy, PhD2;
1University of Manitoba, PhD student, Winnipeg, Canada, 2University of Manitoba, Winnipeg, MB, Canada
1University of Manitoba, PhD student, Winnipeg, Canada, 2University of Manitoba, Winnipeg, MB, Canada
OBJECTIVES: Populations with asthma and chronic obstructive pulmonary disease (COPD) are advised to adhere to their respiratory medications. However, there is scarce evidence on how the COVID19 pandemic has impacted these individuals. We aimed to investigate the trends of respiratory medications (bronchodilators and corticosteroids) and antibiotic prescriptions in asthma and COPD individuals before and during the COVID19 period.
METHODS: A quasi-experimental study using administrative health databases from Manitoba, Canada, between 2007 and 2022, was conducted to create two cohorts: asthma and COPD cohorts. Interrupted time series analysis using autoregressive integrated moving average (ARIMA), with level and slope intervention functions was used to investigate the immediate and lagged effects of the quarterly medication use.
RESULTS: We examined 1,366,361 asthma and 118,369 COPD individuals during the study period. Among asthma individuals, there was a significant increase in the utilization of respiratory medications by 12.26% (p=0.0002) immediately after the onset of the pandemic and a significant decline in the use of respiratory antibiotics by 24.19% (p<0.001). There was a significant increase in trend observed for antibiotic utilization (β3=2.27 and p<0.001) and a significant decline (β3 =1.174 and p<<0.001) for respiratory medications. Among COPD individuals, there was a significant increase in the utilization of respiratory medications by 57.79% (p<0.001) immediately after the onset of the pandemic and a significant decline in the use of antibiotics by 38.26% (p<0.001). Furthermore, the pandemic showed a non-significant lagged effect on antibiotics utilization (β=-0.389 and p=0.629), and (β3=-0.336 and p=0.533) for respiratory medications among COPD individuals.
CONCLUSIONS: A significant immediate decline in the use of antibiotics was observed in both populations following the pandemic restrictions. Furthermore, a significant lagged effect was shown in asthma antibiotic use. Further research is necessary to investigate if those immediate and lagged effects were detrimental to individuals’ health or quality of life.
METHODS: A quasi-experimental study using administrative health databases from Manitoba, Canada, between 2007 and 2022, was conducted to create two cohorts: asthma and COPD cohorts. Interrupted time series analysis using autoregressive integrated moving average (ARIMA), with level and slope intervention functions was used to investigate the immediate and lagged effects of the quarterly medication use.
RESULTS: We examined 1,366,361 asthma and 118,369 COPD individuals during the study period. Among asthma individuals, there was a significant increase in the utilization of respiratory medications by 12.26% (p=0.0002) immediately after the onset of the pandemic and a significant decline in the use of respiratory antibiotics by 24.19% (p<0.001). There was a significant increase in trend observed for antibiotic utilization (β3=2.27 and p<0.001) and a significant decline (β3 =1.174 and p<<0.001) for respiratory medications. Among COPD individuals, there was a significant increase in the utilization of respiratory medications by 57.79% (p<0.001) immediately after the onset of the pandemic and a significant decline in the use of antibiotics by 38.26% (p<0.001). Furthermore, the pandemic showed a non-significant lagged effect on antibiotics utilization (β=-0.389 and p=0.629), and (β3=-0.336 and p=0.533) for respiratory medications among COPD individuals.
CONCLUSIONS: A significant immediate decline in the use of antibiotics was observed in both populations following the pandemic restrictions. Furthermore, a significant lagged effect was shown in asthma antibiotic use. Further research is necessary to investigate if those immediate and lagged effects were detrimental to individuals’ health or quality of life.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH19
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)