Drug utilisation in children and adolescents before and after the start of the COVID-19 pandemic: Interrupted time-series analyses in three European countries

Elisabeth Pedersen, Elena Tripodi, Mia Aakjær, Huiqi Li, Anna Cantarutti, Fredrik Nyberg, Morten Andersen, Angela Lupattelli, Hedvig Nordeng*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

2 Citationer (Scopus)
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Abstract

Background: The COVID-19 pandemic has affected children and adolescents in several ways, including worsened mental health, improvement of asthma, and increases in diabetes ketoacidosis. Less is known about how medication use in children and adolescents has been affected by the pandemic. Objectives: To explore how the COVID-19 pandemic affected drug utilisation in children and adolescents in Norway, Sweden, and Italy, by child age. Methods: We conducted a longitudinal drug utilisation study among all children and adolescents (<18 years old) in Norway and Sweden and a nationwide paediatric database covering 3% of the paediatric population in Italy. We conducted an interrupted time-series analysis from January 2018 to December 2021, with March 2020 as the interruption point. Dispensing or prescription rates of antidepressants, anxiolytics, sleep medications, attention-deficit/hyperactivity disorder (ADHD) medications, insulin, and asthma medications were examined. Results: The study population in January 2018 consisted of 3,455,521 children and adolescents (136,188 from Italy, 1,160,431 from Norway, and 2,158,902 from Sweden). For sleep medications and insulin, there were only minor changes in level or trend in some age groups after March 2020. For asthma medications, the pandemic was associated with an immediate decrease in dispensing in Norway and Sweden (range of change in level: −19.2 to −3.7 dispensings per 1000 person-months), and an increasing trend in all countries afterward (range of change in trend: 0.3–6.4 dispensings per 1000 person-months), especially for the youngest age groups. Among adolescents, the pandemic was associated with an increased trend for ADHD medications, antidepressants, and anxiolytics in Norway and Sweden, but not in Italy. Conclusions: The increasing trend of psychotropic medication dispensing, especially among adolescents after the start of the pandemic, is concerning and should be investigated further. Aside from a temporary effect on asthma medication dispensing, the pandemic did not greatly affect the dispensing of the medications investigated.

OriginalsprogEngelsk
TidsskriftPaediatric and Perinatal Epidemiology
Vol/bind38
Udgave nummer6
Sider (fra-til)450-460
ISSN0269-5022
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This work is performed as part of the Nordic COHERENCE project, project no. 105670 funded by NordForsk under the Nordic Council of Ministers and the EU‐COVID‐19 project, project no. 312707 funded by the Norwegian Research Council's COVID‐19 Emergency Call. The SCIFI‐PEARL project which supplies the data for the Swedish part of this analysis has basic funding based on grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF‐agreement (Avtal om Läkarutbildning och Forskning/Medical Training and Research Agreement) and previously from a joint grant from Forte (Swedish Research Council for Health, Working Life and Welfare) and FORMAS (Forskningsrådet för miljö, areella näringar och samhällsbyggande). The Pharmacovigilance Research Center was supported by a grant from the Novo Nordisk Foundation to the University of Copenhagen (NNF15SA0018404). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2024 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.

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