PharmD Graduate University of Manitoba Winnipeg, Canada
Background: The COVID-19 pandemic reduced access to healthcare services and exacerbated drug supply shortages, leading to transient impacts on prescription utilization for all age groups. However, the impact of COVID-19 on pediatric and adolescent medication usage in Canada is still unknown.
Objectives: To examine the impact of COVID-19 restrictions on the trends of prescription medications use in pediatric and adolescent populations.
Methods: We conducted a population-based study using the administrative health database in Manitoba, Canada, including pediatrics and adolescents. Two periods were compared: before COVID-19 (01 July 2016 to 31 March 2020) and during COVID-19 (01 April 2020 to 31 March 2022). Quarterly changes in prescribed medications were analysed using interrupted time series analyses (autoregressive models) with the second quarter of 2020 as intervention point. Medication classes included antibiotics, antidiabetics, antiseizure, cardiovascular, chemotherapies, corticosteroids, nonsteroidal anti-inflammatory drugs, opioids, proton-pump inhibitors, psychotropics, respiratory, and thyroid medications. We conducted subgroup analyses stratified by age (≤1, >1-3, >3-12, >12 -18), sex and socioeconomic status (SES).
Results: The quarterly study population ranged from 299,748 to 309,282 individuals. Within this cohort, the mean age was 8.94 years (SD=5.15) and 51.3% of the population were males. Of the comorbidities captured, the most common were asthma (23.6%) and ADHD (4.6%). Overall, pandemic restrictions were associated with a 38.7% (p=0.003) relative decrease in overall prescription utilization for all examined medications followed by an increase during the pandemic (β3=0.393, p=0.2314). Immediately after the onset of the pandemic restrictions, subgroup analysis showed a relative decline by 40.3% (p=0.0002) in males, 37% (p=0.0003) in females, 39.2% (p=0.0009) in higher and 38.6% (p < 0.0001) in lower SES groups. Significant relative declines were observed among all age groups, ranging between 25.9% and 53.7%. Non-significant rebound increase in medication utilization was observed in the following seven quarters.
Conclusions: Our findings show a significant decrease in prescribed medications use among the pediatric and adolescent populations immediately following COVID-19 restrictions, without a substantial rebound to pre-pandemic baseline levels. The observed declines were consistent among different age, sex, and socioeconomic groups. This study will further investigate the COVID-19 impact on the use of each medication class among children and adolescents.
