ABSTRACT
BACKGROUND: The COVID-19 pandemic has impacted the sexual health and well-being of individuals, directly through risk of contracting COVID-19, and indirectly through government lockdowns. Government restrictions were especially strict and long-lasting in Australia, they also varied by state, offering an interesting opportunity to study the impacts of varying restrictions. This study compares the impact of the COVID-19 pandemic and resulting restrictions on chlamydia treatment prescriptions during 2020, through to July 2021 between different states and demographic groups in Australia. METHODS: The rate of prescriptions per 100,000 population filled each month from January 2017 to July 2021 from Australia's Pharmaceutical Benefits Scheme for Azithromycin with a restricted indication to treat Chlamydia trachomatis was used to measure chlamydia treatment. The impact of COVID-19 lockdowns was modeled using an interrupted time-series Poisson regression model. RESULTS: The data included 520,025 prescriptions to treat chlamydia, averaging 37.5 prescriptions per month per 100,000 population. Prescriptions declined 26% in April to May 2020 when initial COVID-19 lockdowns began in Australia; prescriptions increased in the following months but remained on average 21% below prepandemic (2017-2019) levels through to July 2021. Prescriptions declined the most in 1 Australian state, Victoria, both in the initial lockdown and the following period; generally, states with more COVID-19 cases saw bigger reductions in prescriptions. CONCLUSIONS: This is the first study to examine how treatment for chlamydia in Australia was impacted by the COVID-19 pandemic and restrictions not only in the immediate-term, but also ongoing up to July 2021, providing important information for planning for sexual health services in future pandemics.
Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Communicable Disease Control , Victoria , Azithromycin/therapeutic useABSTRACT
Effective consumer centred healthcare incorporates consumer and clinician perspectives into decision making, in addition to traditional quantitative measures. This information is usually captured in qualitative data that requires manual analysis. Healthcare systems often lack resources to systematically incorporate qualitative feedback into decision making. Semi-automated content analysis tools, such as Leximancer, provide an efficient and objective alternative to time consuming manual content analysis (MCA). Literature on the validity of Leximancer in healthcare is sparse. This study seeks to validate Leximancer against MCA on a broad emotive conversational dataset gathered in a healthcare setting. At the outset of the COVID-19 pandemic, a large Australian hospital and health service conducted interactive webcasts with staff to provide updates and answer questions. A manual thematic analysis and a Leximancer content analysis were conducted independently on 20 webcast transcripts. The findings were compared, along with the time required to the complete each analysis. The Leximancer analysis identified nine concepts, while the manual analysis identified 12 concepts. The Leximancer concepts mapped to five of the concepts identified in the manual analysis, which accounted for 74% of mentions tagged in the text through the manual analysis. Leximancer missed concepts which required an emotional or contextual interpretation. The Leximancer analysis took 21 hours (excluding time to learn the program), compared to 73 hours for the manual analysis. Semi-automated content analysis provides an efficient alternative to manual qualitative data analysis, shifting it from a small-scale research activity to a more routine operational activity, albeit with some limitations. This is critical to be able to utilise at scale the rich narratives from consumers and clinicians in healthcare decision making.
ABSTRACT
The COVID-19 pandemic has impacted the management of non-communicable diseases in health systems around the world. This study aimed to understand the impact of COVID-19 on diabetes medicines dispensed in Australia. Publicly available data from Australia's government subsidised medicines program (Pharmaceutical Benefits Scheme), detailing prescriptions by month dispensed to patients, drug item code and patient category, was obtained from January 2016 to November 2020. This study focused on medicines used in diabetes care (Anatomical Therapeutical Chemical code level 2 = A10). Number of prescriptions dispensed were plotted by month at a total level, by insulins and non-insulins, and by patient category (general, concessional). Total number of prescriptions dispensed between January and November of each year were compared. A peak in prescriptions dispensed in March 2020 was identified, an increase of 35% on March 2019, compared to average growth of 7.2% in previous years. Prescriptions dispensed subsequently fell in April and May 2020 to levels below the corresponding months in 2019. These trends were observed across insulins, non-insulins, general and concessional patient categories. The peak and subsequent dip in demand have resulted in a small unexpected overall increase for the period January to November 2020, compared to declining growth for the same months in prior years. The observed change in consumer behaviour prompted by COVID-19 and the resulting public health measures is important to understand in order to improve management of medicines supply during potential future waves of COVID-19 and other pandemics.