Gonadorelins adherence in prostate cancer: A time‐series analysis of England’s national prescriptions during the COVID‐19 pandemic (from Jan 2019 to Oct 2020)

Abstract

Objective To examine the effect of the COVID‐19 pandemic on gonadorelin analogue prescription for community patients in England. Materials and methods We included data from all primary‐care patients who had relevant prescriptions dispensed in the community in England. Descriptive statistics and interrupted time series analysis over 22 months (15 months before and 7 months after lockdown) was evaluated. Results A total of 22 months’ worth of data were analyzed (or 1 041 638 total items, monthly average 47 347 items). Goserelin; leuprorelin, and triptorelin are the medicines most used by total quantity in the study period. Simple descriptive statistics show that mean values have declined during the pandemic. The Interrupted Time Series (ARIMA Modeling) shows declining trends. After the pandemic's onset, we observe a statistically significant downward trend for goserelin ( P = .017) and leuprorelin ( P = .014). As these are the major constituents of the model, we interpret this overall data as showing a significant downward category trend. Aside from linearity, a significant step change was noted for leuprorelin ( P = .029) showing an increase in prescription items with a similar effect that is close to being statistically significant for goserelin ( P = .051). The actual cost of medicines shows minimal variation suggesting that prices of individual medicines have remained stable. The regional data showed variation but this was not statistically significant. In all cases, the Oct‐20 figures are lower “year on year.” This novel work reports the impact of a global pandemic on prescription volumes of prostate cancer (PCa) medicines. Conclusions A worrying decrease in prescription medicines raises concerns for the care of PCa patients. We encourage diagnosed patients to discuss their planned care with their doctor.

Adherence to Hormonal Therapies in Prostate Cancer

“…A study in England investigated if COVID-19 would affect community prescription issuance of GnRH receptor agonists during the first wave of the pandemic from March 23 to October 31 in 2020. 28 After the onset of the pandemic, a statistically significant downward trend was observed in the estimated change in prescription volumes for goserelin (before March 2020, 59; P ¼ .058 and after March 2020, À270; P ¼ .017) and leuprolide (before March 2020, 39; P ¼ .211 and after March 2020, À292; P ¼ .014). For triptorelin acetate, there was a As an example, if a patient prescribed a daily oral medication has a prescription that finishes on the 22nd of a 30-day month, but refills on the 24th, PDC or MPR is calculated as 28 out of 30 days in that month, with 96.7% adherent rate (A).…”

Impact of the COVID-19 pandemic on prescription refills for immune-mediated inflammatory disorders: a time series analysis (January 2019 to January 2021) using the English Prescribing Dataset

“…Microsoft Visual Studio was used to create and edit SQL Server Integration Services packages that imported, validated and consolidated the data within an automated import routine. Detailed methods have been previously published 46 in supplemental. Data were aggregated by month, chemical substance, regional office name and BNF code, to allow for human analysis.…”

Impact of the COVID-19 pandemic on cardiovascular heart disease medication use: time-series analysis of England’s prescription data during the COVID-19 pandemic (January 2019 to October 2020)

“…An interrupted time-series (ITS) design 43 – 45 at 95% confidence level was used, which provides powerful evidence of causal effects because it controls for secular trends in study outcomes. The Cochrane Resources 43 form the ‘benchmark’ methodology for this study, and others have previously used the Box–Jenkins techniques 21 , 22 , 23 , 25 , 26 , 46 – 50 described here. A commonly used time-series modelling framework [autoregressive integrated moving average (ARIMA)] to analyse the monthly total quantity of prescription data from the EPD was employed.…”

“…Not much is known about rates of cardiovascular events in ambulatory patients during the COVID-19 pandemic, nor rates of CVD drug adherence during the lockdown. However, recent evidence is emerging from the United Kingdom that plausibly connects the onset and course of the pandemic to temporal changes in drug series [21][22][23][24] [for gonadorelins, calcineurin inhibitors, asthma and chronic obstructive pulmonary disease (COPD) medicines, and anticoagulants], trends that are being observed globally, providing an early signal for some form of system fragility or system failure with reduced prescription drug coverage. 25,26 Normal clinical practice Patients with long-term routine chronic conditions such as hypertension and related cardiovascular conditions are on routine repeat medication prescriptions in normal clinical practice.…”