Psychotropic prescribing in UK primary care during the COVID-19 pandemic: national interrupted time-series analysis.
The COVID-19 pandemic disrupted healthcare delivery and coincided with increased psychological distress worldwide. In the UK, restrictions on healthcare access, rapid adoption of remote consultations and pressures on mental health services may have influenced prescribing of psychotropic medications. However, evidence comparing prescribing trends across the four UK nations during the pandemic remains limited.
To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.
We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.
Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (-9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.
Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.
To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.
We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.
Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (-9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.
Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.
Authors
Kurdi Kurdi, Alrahmani Alrahmani, Bakar Bakar, Johnson Johnson, Godman Godman
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