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Impact of COVID-19 on Patterns of Drug Utilization: A Case Study at National Hospital

Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le

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.

Objectives

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.

Introduction

In December 2019, a new strain of Coronavirus (SARS-CoV-2) causing acute respiratory infections was identified in Wuhan City, China [1]. This disease, later named COVID-19, rapidly spread worldwide, resulting in severe consequences for healthcare systems in various countries. To address the complex epidemic situation, many countries implemented control measures aimed at mitigating the spread of COVID-19 within communities [2,3]. The pandemic had a significant impact on several hospital services, particularly outpatient care. During the initial stages of the outbreak, there was a notable decline in outpatient visits due to curfews and concerns about infection in public spaces [4–6]. Additionally, the global disruption of supply chains caused by COVID-19 has posed a serious challenge for patients who are relying on long-term medication use, impeding their access to prescription drugs [4,7].

Methods

Study setting and design

A longitudinal single-center study was used to evaluate the impact of COVID-19 on the utilization trends of selected drugs among outpatients. The study conducted in Thong Nhat hospital located in Ho Chi Minh City, which is one of the largest national geriatric hospitals and the largest geriatric hospital in Viet Nam and the Southern Viet Nam, respectively. Data were derived from electronic medical database owned by Thong Nhat hospital. During the fourth wave of COVID-19, Thong Nhat hospital was in charge of a 1000 bed multi-class COVID-19 field hospital named Tan Binh district field hospital. Although there was a surge in new cases of COVID-19 during our study period, outpatient data in Thong Nhat hospital would not recorded a great number of COVID-19 confirmed patients since these patients were gathered and treated in the field hospital.

Results

Characteristics of the data population

A total of 1,060,507 and 644,944 outpatients’ prescriptions at Thong Nhat Hospital were included in this study during Period 1 (January 2016 to December 2020) and Period 2 (January 2021 to December 2022), respectively. In the first period, the percentage of patients aged from 30 to below 60 was the highest prevalence. However, the age group accounted for the highest proportion in period 2 was the elderly group (from 60 years old and older). The median age in Period 1 and Period 2 were 58 (46–68) and 67 (58–76) years old, respectively. The analysis of diagnosed diseases revealed noteworthy changes. The proportion of individuals with a single diagnosed disease decreased from 23.74% (Period 1) to 10.85% (Period 2). While the prevalence of individuals with multiple diagnosed diseases, notably six or more, increased substantially from 1.48% to 15.05%. The CCI was distributed similarly between the two periods. However, the prevalence of individuals with no comorbidities decreased slightly from 85.38% (Period 1) to 82.18% (Period 2). The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. There were notable increases in the prevalence of GERD (from 3.29% to 5.10%) and Angina pectoris (from 1.04% to 5.32%) Table 1.

Discussion

COVID-19 has significantly disrupted the treatment of patients with multiple chronic conditions [4,12–14]. In many countries, telemedicine services have been widely adopted to ensure a continuous drug supply while minimizing the risk of COVID-19 transmission [33]. However, Viet Nam has not implemented telemedicine services as extensively [27]. In our observations, we found that patients, especially those with chronic diseases, resorted to psychological stockpiling of drugs as a coping mechanism during the prolonged period of social distancing and restrictions imposed by the pandemic. In order to prepare before the stay-at-home orders, patients in some US states having US insurance were accepted to claim extra drugs early, in turn leading to a surge in refilling prescriptions at the onset of COVID-19 [17]. Unfortunately, due to confidentiality issues in accessing databases, we were unable to quantitatively interpret the extent of psychological stockpiling of drugs among hospital patients. This situation underscores the need for further investigation and the prompt development of a comprehensive strategy for managing chronic conditions in the event of similar situations, such as future outbreaks like COVID-19.

Conclusion

COVID-19 led to a sudden non-significantly increase in overall drugs consumptions level. Additionally, our findings highlight the significant increases in the use of three groups in the drugs active on cardiovascular system, which are cardiac therapy, beta-blocking agents and antihypertensives. Interestingly, we found a statistically significant increase in consumption level of antigout preparations, contrary to the decline on monthly consumptions rate of NSAIDs. Further studies in the following years are needed to provide a better scenario of COVID-19 impact on outpatient’s drug utilization patterns.

Citation: Le-Dang M-A, Nguyen-Thi H-Y, Dinh LP, Ngoc DL, Le NDT, Thu HP, et al. (2024) Impact of COVID-19 on patterns of drug utilization: A case study at national hospital. PLoS ONE 19(1): e0297187. https://doi.org/10.1371/journal.pone.0297187

Editor: Chinh Quoc Luong, Bach Mai Hospital, VIET NAM

Received: August 2, 2023; Accepted: December 31, 2023; Published: January 19, 2024

Copyright: © 2024 Le-Dang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data utilized in this study were obtained from the electronic medical record database of Thong Nhat Hospital, located in Ho Chi Minh City, Vietnam. It is imperative to note that the data employed herein are of a strictly confidential nature and remain under the ownership of the hospital's governing authority. For inquiries regarding access to this data, kindly direct your correspondence to Ms. Tien Phung via email at [email protected].

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

 

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297187#abstract0

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