Decrease in prescriptions during the pandemic could be leading to avoidable deaths from heart disease and strokes

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Medicines used to treat serious and long term conditions are not being prescribed as often as they should be expected following the pandemic, raising fears that this could be causing avoidable deaths from heart disease and strokes.

New analysis by Analytics firm LCP of data on almost 9 billion prescriptions dispensed by pharmacies in England between 2017 and 2022, has highlighted that blood thinners and hormone treatments for cancer are among those that have seen a marked decrease in prescriptions since Covid hit. 

Blood thinners reduce the risk of blood clots and can prevent strokes, but prescriptions are 5% lower than expected which means more people could be having avoidable strokes.

Prescriptions for hormone treatments for certain types of breast and prostate cancer are also 4.4% lower than expected which could be the result of delays in diagnosing people with cancer and starting them on treatment.  

Some medicines have seen an increase in use such as treatments for coughs and respiratory diseases – potentially related to the treatment of the symptoms of Covid or Long Covid.

Dr Danielle Robinson, Epidemiologist in LCP’s health team, commented: “The changes in prescribing are another stark example of the long term impact that the pandemic induced backlog is having on our health services. The likeliest explanation for the decline in prescriptions for cancer hormones and blood thinners is delays or missed diagnoses because of the backlog.”

Dr Ben Bray, Principal in the Health Analytics team, added: “We know that heart disease and stroke deaths were the largest contributors to excess deaths in the community for men in 2020 and the changes that we are seeing in prescription patterns could explain why we may be seeing more people dying from these type of diseases. Trying to tackle the backlog is a mammoth task for policymakers, but data like this is crucial to making sure the right patients and issues are targeted.”

Industry expert, Dr Deborah Layton, PhD FRPharmS FISPE, Director PEPI Consultancy Limited, UK, said: “No-one can deny that the impact of the pandemic on provision of healthcare has been profound. A study by Robinson et al (LCP) presented at ICPE tracked shifts in prescribing of 50 medication classes using time trend analyses on data from nearly 9 billion prescriptions collected on medicines dispensed in community pharmacies between Jan2014 and April 2022. In brief, the results demonstrate a surge in prescribing of medications for symptomatic relief of relatively minor (acute) respiratory conditions and health supplements, with a concurrent decline in prescribing of medications for chronic disease. The authors also report that these changes have not returned to pre-pandemic levels. Whilst this elegant study illuminates changes in health service provision arising during the pandemic, it does not necessarily imply a causal relationship. Nevertheless studies like this inform us further of changes in services, particularly in primary care that we are now just getting to understand.”

Notes to editors

LCP analysed data about prescription medicines dispensed from pharmacies in England to track the trends in medicine usage before, during and after the pandemic. By projecting forward the trends and patterns that existed before March 2020, the team compared the actual prescriptions with what would have happened if the pandemic had not occurred. A substantial change was classified as 3% + increase or decrease when the expected number of prescriptions was compared to the observed number of prescriptions.

The findings were presented this week at this year’s International Society for Pharmacoepidemiology conference in Copenhagen, Denmark

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