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Thorax ; 76(Suppl 2):A26-A27, 2021.
Article in English | ProQuest Central | ID: covidwho-1505867


Introduction and ObjectiveThe COVID-19 pandemic has witnessed a reduction in asthma exacerbations in the UK. Several factors may underpin this, including reduced transmission of seasonal viruses and improved use of or adherence to inhaled corticosteroids (ICS). This study aims to investigate whether ICS use has changed during the pandemic for patients with asthma.MethodsUsing the OpenPrescribing database, we analysed prescribing patterns of ICS, salbutamol and peak flow meters from January 2019 to January 2021 across England. Additionally, using a sample asthma cohort from 3 primary care practices, we assessed individual prescription patterns and ICS adherence across the two-year period. ICS adherence has been defined according to the medication possession (MPR) ratio: good (≥75%), sub-optimal (50–74%), poor (25–49%) and non-adherence (<25%).ResultsA sharp increase in national ICS prescriptions was observed at the start of the pandemic in March 2020 representing a 50% increase compared to February 2020. Thereafter national ICS prescription rates appear to have returned to normal levels. The sample asthma cohort included 1132 patients (762 patients treated with ICS across 2019 and 2020). Overall, adherence to ICS improved in 2020 (P<0.001), with the proportion of patients meeting ‘good adherence’ (≥75%) increasing from 34% to 42% (P<0.001). Analysis of this cohort suggested the March 2020 spike predominantly reflected improved adherence rather than a hoarding effect of multiple inhalers or new prescriptions for ICS-naïve individuals. Increasing age was associated with higher levels of ICS adherence. A similar spike in salbutamol occurred in March 2020, however, an overall reduction in salbutamol prescriptions was seen in 2020 (P=0.039). National figures highlighted a progressive increase in prescription of peak flow meters over 2020.ConclusionA marked spike in national ICS prescriptions occurred in March 2020. This increase appears to reflect improved adherence in patients with low levels of adherence rather than a hoarding effect or large-scale initiation in ICS-naïve patients. Despite a comparable spike in salbutamol prescriptions, 2020 saw an overall reduction in salbutamol prescriptions. Prescription of peak flow meters steadily increased over 2020 in keeping with the need for more remote monitoring.