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Prescription of anxiolytics, sedatives, hypnotics and antidepressants in outpatient, universal care during the COVID-19 pandemic in Portugal: a nationwide, interrupted time-series approach
  1. Marta Estrela1,
  2. Tânia Magalhães Silva1,
  3. Eva Rebelo Gomes2,
  4. Maria Piñeiro3,4,
  5. Adolfo Figueiras3,4,
  6. Fátima Roque5,6,
  7. Maria Teresa Herdeiro1
  1. 1iBiMED - Institute of Biomedicine - Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
  2. 2Allergy and Clinical Immunology Service, University Hospital Center of Porto, Porto, Portugal
  3. 3Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
  4. 4Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
  5. 5Research Unit for Inland Development, Guarda Polytechnic Institute, Guarda, Portugal
  6. 6Health Sciences Research Centre, University of Beira Interior, Covilhã, Castelo Branco, Portugal
  1. Correspondence to Marta Estrela, iBiMED - Institute of Biomedicine - Department of Medical Sciences, University of Aveiro, Aveiro, Portugal; mestrela{at}ua.pt

Abstract

Background The COVID-19 pandemic has had a significant impact on the population’s mental health. However, its impact on the consumption of anxiolytics, sedatives, hypnotics and antidepressants remains to be evaluated. Hence, this article aims to assess the prescription trends of these drugs in Portugal, from January 2018 to March 2021, while critically examining whether the COVID-19 pandemic had an impact on these prescription trends or not.

Methods A nationwide interrupted time-series analysis of the prescription data of anxiolytics, sedatives, hypnotics and antidepressants in outpatient setting of the public health sector was conducted. The data encompassed the defined daily dose per month, age range and sex and were analysed following a segmented regression approach.

Results The pandemic preceded an immediate reduction in the prescription of anxiolytics, sedatives and hypnotics for children and adolescents. However, an increasing trend throughout the pandemic has been noted in the prescription of these drugs, especially among adults aged 65 years or above. A drop in antidepressant prescription was observed as an immediate effect of the pandemic among male and female adolescents and elderly women. From March 2020 to March 2021, a decreasing prescription trend has been noted among men.

Conclusions When analysing specific genders and age ranges, differences can be noted, in terms of both immediate impact and prescribing trends throughout 1 year of the COVID-19 pandemic. The impact of the pandemic on mental health and its association with the consumption trends of psychoactive drugs, and with the access to mental health treatments, should be further assessed.

  • COVID-19
  • mental health
  • pharmacoepidemiology
  • public health
  • time-series

Data availability statement

Data are available in a public, open access repository.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/jech-2021-216732

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    Data availability statement

    Data are available in a public, open access repository.

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    Footnotes

    • Twitter @marta_r_estrela

    • Contributors TH, FR and AF were involved in conceptualisation; ME, TMS, EG, MP-L. FR, TH and AF in methodology; ME, TMS, MP-L and AF in software; TH, FR, AF and EG in validation; ME, AF, FR and TH in formal analysis; ME in writing—original draft preparation; ME, TMS, EG, MP-L, AF, FR and TH in writing—review and editing; ME, TMS,EG, MP-L, AF, FR and TH in visualisation; TH, AF and FR in supervision; and TH and FR in project administration. All authors have read and agreed to the published version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.