Background: The 2019 coronavirus disease (COVID-19) poses great demands on hospitals and resulted in delayed care. It can be hypothesized that this delayed professional health care is reflected in a reduction of pharmacy dispensed analgesics.
Objective: The purpose of this study was to investigate the possible impact of COVID-19 lockdown on the dispensing rates of analgesics drugs by Dutch pharmacies.
Methods: Pharmacy dispensing data was obtained from Stichting Farmaceutische Kentallen on newly dispended analgesics (ATC2 N02), covering 1890 pharmacies and 96% of the Dutch population. Over-the-counter (OTC) painkillers were not considered. Age and sex of the patient were recorded, as well as the week of first-time dispensed drugs. Data were collected for the first half year of 2019 and the first half year of 2020. Patients were allocated to one of the following age groups: children (0-9 years old), adolescents (10-19 years old), adults (20-64 years old), and elderly (65 year and older). Further, data was combined into three time periods: week 1-11 (for 2020 corresponding to the pre-COVID-19 lockdown period), week 12-19 (for 2020 corresponding to the COVID-19 lockdown), and week 20-26 (for 2020 corresponding to the post-COVID-19 lockdown). Using independent t-tests, dispensing data was compared between males and females, age groups, and between 2019 and 2020.
Results: An overall reduction was observed in the first half of 2020 for the number of newly dispensed analgesics (379.657 in 2019 and 360.094 in 2020, respectively). In both years, analgesics were significantly more often dispensed to females than to males, and most were prescribed to adults followed by the elderly. In addition, significantly more analgesics were dispensed in week 1-11 compared to the other time periods. In male children, compared to 2019 the reduction was only significant during the COVID-19 lockdown in 2020. For female children, no significant differences were found. For adolescents of both sexes, compared to 2019, a significantly reduced number of dispensed analgesics was found for all three time periods (p<0.001). In adults of both sexes, the reduction in dispensed analgesics in 2020 was only significant during the COVID-19 lockdown. In elderly, a reduction in dispensed analgesics in 2020 was found for pre- and during the COVID-19 lockdown (p<0.001), but not post-COVID-19 lockdown. In elderly males, a significant reduction in 2020 was found for pre-COVID lockdown, but not thereafter. For elderly females, the reduction in 2020 was significant for both week pre- (p<0.001) and during COVID-19 lockdown (p=0.02), but not thereafter.
Conclusions: These findings show that the number of dispensed analgesics was significantly lower in 2020 compared to 2019. The reduction in dispensed analgesics was most consistently seen for the 2020 COVID-19 lockdown period, reflecting delayed professional health care across all age groups. Future research should investigate whether, due to delayed care, a substantial number of patients may have suffered from untreated pain complaints during the 2020 COVID-19 lockdown, or whether they have established pain relief via non-prescription painkillers.
No conflict of interest