Outpatient prescription patterns of COVID-19 drugs in the metropolitan area of Mexico City

Abstract

Background We aimed to describe the use of drugs with apparent efficacy in ambulatory patients with confirmed COVID-19 and the relationship of Google Trends searches with prescriptions and the total number of COVID-19 cases in Mexico City. Methods Between March 2020 and February 2021, we surveyed 350 patients confirmed to have COVID-19 across 3 hospitals in Mexico City for their ambulatory prescriptions. We analysed the correlation between prescription patterns of 4 drugs with apparent efficacy against COVID-19, Google Trends searches for these drugs, and the overall number of confirmed COVID-19 cases in Mexico City. Results We included 350 patients, of whom 59% were women with a median age of 38 years (interquartile range, 29–51), and 72% had a bachelor’s degree or higher. There were ambulatory medical prescriptions in 172 (49%) patients, and self-prescriptions were reported in 99 (28%) patients. The prescription rate was high for hydroxychloroquine/azithromycin (19%) and dexamethasone (25%). There was a decrease in the prescription of hydroxychloroquine (P < 0.001) and a strong positive correlation between hydroxychloroquine (r = 0.66; 95% confidence interval, 0.11–0.90; P = 0.02) prescription and online searches for hydroxychloroquine. There was a strong positive correlation between online searches for azithromycin, dexamethasone, ivermectin, and vitamin D and the number of confirmed COVID-19 cases. Conclusions During the COVID-19 pandemic, there was a high proportion of prescriptions for hydroxychloroquine/azithromycin and dexamethasone despite their unproven efficacy. Analysis of Google Trends showed a strong correlation between the overall number of confirmed COVID-19 cases and searches for such drugs, suggesting a higher rate of prescriptions. Analysis of online searches could thus help to actively survey public health behaviours in the future.

Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru

“…During the COVID-19 pandemic, increasing prescription and self-medication of off-label drugs with unproven efficacy and safety to treat this disease has been described in many countries. [13][14][15] In our study, the frequency of ivermectin consumption in the Chincha province was 67.2%, with more than 50% self-medicating and 43.5% obtaining the drug by medical prescription.…”

Descriptive epidemiology of COVID-19 in Japan 2020: insights from a multihospital database

“…Although medication use may have been underreported in a minority of cases, the present study demonstrated that the use of repurposed drugs was largely evidence-based because unauthorized medication use was highly limited in 2020. This situation was in contrast to that in other countries, where repurposed drug use of ivermectin or hydroxychloroquine (inexpensive oral medications) was relatively common [33][34][35]. In some countries, these drugs were proposed as therapeutic options, such as the emergency use authorization of hydroxychloroquine in the United States (which was subsequently revoked) [36].…”

Association between self-reported evidence-based medicine competencies and prescribing of drugs without scientific evidence against mild COVID-19 among recently graduated physicians in Peru

“…Previous studies have shown that the prescription of non-evidence-based medications for the treatment of COVID-19 is frequent, ranging from 28 to 29% [ 42 , 43 ]. Furthermore, a previous study evaluated the factors influencing medication prescription for COVID-19 [ 44 ].…”