Changes in Prescribing of Psychotropic Medication in Primary Care through the COVID-19 Pandemic in England: A National Level Prospective Survey

Abstract BackgroundThe COVID-19 pandemic globally impacted healthcare provision. Prescribing changes of common medications can be used as a marker for new diagnoses.AimTo describe how psychotropic prescribing in England was affected by the COVID-19 pandemic.MethodsPrimary Care Prescribing data for different classes of drug from March 2017 - February 2022 were considered. To capture the impact during periods of restricted access to health services for new diagnoses/existing conditions, repeat prescriptions/episodic prescribing were included with account taken of historical trend.The pre-pandemic prescriptions issued each month from March 2017 - February 2020 were linearly extrapolated forward to give an expected annual growth (EAG). The monthly average expected prescriptions for the pandemic period (March 2020–February 2022) were compared with this.ResultsPhysical health medications had lower monthly prescriptions during the pandemic with antibiotics down -12.2%(EAG -1.4%). Most repeat prescriptions were for bronchodilators -1.8%(EAG 0%), hypertension and heart failure -1.3%(EAG 1%), and lipid regulating drugs at -0.1%(EAG 2.3%). Mental Health monthly prescribing increased with hypnotics/anxiolytics by 0.6%(EAG -2.4%), antipsychotics by 0.5%(EAG 2.7%) and antidepressants by 0.3% (EAG 4.9%) The three main antidepressant were: Sertraline grew by 21% so its share of total anti-depressants increased from 22.7% to 24.6% (+8%), Mirtazapine grew by 16% so share increased from 13.0% to 13.6% (+5%), Venlafaxine grew by 11% so share stayed at 6.3%(0%).ConclusionThe increase in anxiolytic/hypnotic prescribing above trend links to pandemic effects on anxiety/worry. The slight increase in antipsychotic prescribing may relate to antipsychotic use in care homes.