Journal Article Ppublish 2 citations
PubMed: 36510392 DOI: 10.1111/imj.15996
Changes in inpatient medicine prescribing during COVID-19 lockdown.
Intern Med J 53(6):917-922
Authors: Millie Y Wang, Murray L Barclay, Paul K L Chin, Matthew P Doogue
Affiliations
- Department of Clinical Pharmacology, Christchurch Hospital, Christchurch, New Zealand.
- Departments of Clinical Pharmacology and Gastroenterology, Christchurch Hospital, Christchurch, New Zealand.
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
Abstract
BACKGROUND
New Zealand went into lockdown March 2020 successfully eliminating the circulation of the coronavirus disease 2019 (COVID-19) virus. During lockdown there were reduced rates of respiratory infections and hospital admission numbers were low. At the time, rumours of benefit and harm of medicines for COVID-19 were widespread in the lay and medical media.
AIM
To describe changes in inpatient prescribing in an acute general medicine service during the New Zealand COVID-19 lockdown in 2020.
METHODS
Rates of prescribing of medicines during the 33 days of lockdown were compared with a 33-day control period before lockdown. Prescriptions, patients and bed days were calculated from the hospital patient administration and electronic prescribing and administration systems.
RESULTS
In the general medicine service, acute admissions were 20% lower during lockdown (from 1216 pre-lockdown to 974). There was a small decrease in the rate of prescriptions per patient (10.1 vs 10.4, P = 0.01) during lockdown, and the average length of stay was shorter (3.2 vs 3.6 days). Nebulised administration decreased by 75% (1.3% vs 5.3% of admissions) but unexpectedly there was no change in the prescribing rates of antibacterial medicines, e.g. amoxicillin (26% vs 26%). There were no changes in rates of prescribing of medicines being rumoured to potentially improve (e.g. hydroxychloroquine) or worsen (e.g. angiotensin-converting enzyme inhibitors) COVID-19 outcomes.
CONCLUSIONS
Acute medical admissions decreased 20% during lockdown for COVID-19, with a proportional decrease in prescriptions. Reduced rates of respiratory tract infections did not lead to decreased prescribing of antibacterial medicines. Rumour-based prescribing did not eventuate.
MeSH
Length Of Stay, Angiotensin-Converting Enzyme Inhibitors, Respiratory Tract Infections, Internal Medicine, Prescriptions, Electronic Prescribing, Covid-19, Sars-Cov-2