Using OpenPrescribing.net to evaluate neighbourhood-level prescribing of inhalers for asthma and COPD

Using OpenPrescribing.net to evaluate neighbourhood-level prescribing of inhalers for asthma and COPD | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Using OpenPrescribing.net to evaluate neighbourhood-level prescribing of inhalers for asthma and COPD Thomas C. Richards, Alison Heppenstall, Rachel Oldroyd, Victoria Barr, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5394718/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 May, 2025 Read the published version in Scientific Reports → Version 1 posted 8 You are reading this latest preprint version Abstract Prescribing of inhalers for asthma and Chronic Obstructive Pulmonary Disease is complicated due to multiple treatment pathways, diverse products, and variability in patients’ needs and usage habits. Factors such as social deprivation, air quality, and differences primary access influence both demand on respiratory medications and the rate and manner in which they are prescribed. Inhaler prescribing metrics are valuable for analysing temporal and geographic prescribing patterns across socio-economic groups, whether to identify areas with higher disease incidence or to assess problematic prescribing practices. Using data from OpenPrescribing.net, we estimate prescription items dispensed for different inhaler drugs in England at Lower Layer Super Output Area or ‘neighbourhood’ level. Generating metrics at small-area level enables analysis of the interactions between individuals, their environment, and the localised health system within which they are being treated. This approach complements a patient-centred clinical model that considers individual patient needs. To explore changes pre- and post- the March 2020 COVID-19 lockdown, we profile prescribing temporally and by neighbourhood-level deprivation, measured by the Index of Multiple Deprivation. We use several indicators of prescribing behaviour or potential ‘prescribing stress’, instances where prescribing trends appear to contradict best-practice prescribing, informed by national clinical guidelines. We find inequalities in prescribing behaviour, with the most deprived neighbourhoods associated with higher rates of emergency or ’rescue’ inhaler prescribing - a pattern that was interrupted during the March 2020 lockdown. Additionally, we find an increase in the prescribing of less environmentally friendly inhalers, contrary to national prescribing guidelines. This trend persisted until early 2022, when the trend began to reverse. Whilst many complex factors influence prescribing behaviour and safety, area-level deprivation appears to be an important dimension. Health sciences/Health care Health sciences/Health care/Health care economics Health sciences/Health care/Health policy Health sciences/Health care/Health services Health sciences/Health care/Public health Biological sciences/Physiology/Respiration Earth and environmental sciences/Environmental sciences/Environmental impact Health sciences/Risk factors Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 24 May, 2025 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 28 Apr, 2025 Reviews received at journal 25 Apr, 2025 Reviews received at journal 15 Apr, 2025 Reviewers agreed at journal 08 Apr, 2025 Reviewers agreed at journal 08 Apr, 2025 Reviewers invited by journal 06 Apr, 2025 Submission checks completed at journal 03 Apr, 2025 First submitted to journal 25 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5394718","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":440268173,"identity":"f81410ca-7e94-4175-b6ab-c51a38fa3e39","order_by":0,"name":"Thomas C. 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Factors such as social deprivation, air quality, and differences primary access influence both demand on respiratory medications and the rate and manner in which they are prescribed. Inhaler prescribing metrics are valuable for analysing temporal and geographic prescribing patterns across socio-economic groups, whether to identify areas with higher disease incidence or to assess problematic prescribing practices. Using data from OpenPrescribing.net, we estimate prescription items dispensed for different inhaler drugs in England at Lower Layer Super Output Area or ‘neighbourhood’ level. Generating metrics at small-area level enables analysis of the interactions between individuals, their environment, and the localised health system within which they are being treated. This approach complements a patient-centred clinical model that considers individual patient needs. To explore changes pre- and post- the March 2020 COVID-19 lockdown, we profile prescribing temporally and by neighbourhood-level deprivation, measured by the Index of Multiple Deprivation. We use several indicators of prescribing behaviour or potential ‘prescribing stress’, instances where prescribing trends appear to contradict best-practice prescribing, informed by national clinical guidelines. We find inequalities in prescribing behaviour, with the most deprived neighbourhoods associated with higher rates of emergency or ’rescue’ inhaler prescribing - a pattern that was interrupted during the March 2020 lockdown. Additionally, we find an increase in the prescribing of less environmentally friendly inhalers, contrary to national prescribing guidelines. This trend persisted until early 2022, when the trend began to reverse. 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