Dispensing Patterns of Inhaled Asthma Medication Before and During COVID-19 Among Young Adults in the Netherlands: A Retrospective Inception Cohort Study
Year: 2025
Type: article
Abstract: Guiling Zhou,1 Irene Mommers,1 Catharina CM Schuilinga-Veninga,1 Jens HJ Bos,1 Katrien Oude Rengerink,2 Anna Maria Gerdina Pasmooij,2 Peter GM Mol,2,3 Debbie van Baarle,4 Geertruida H de Bock,5 Job FM van Boven,3,6 Eelko Hak1 1Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, The Netherlands; 2Dutch Medicines Evaluation Board, Utrecht, The Netherlands; 3Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 4Virology and Immunology Research Group, Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 5Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 6Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsCorrespondence: Guiling Zhou, Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands, Tel +31 503638707, Fax +31 503632772, Email [email protected]: The impact of the coronavirus disease 2019 (COVID-19) pandemic on asthma medication trajectories, including changes in medication type or dosage, remains unclear. This study compared dispensing patterns among adults who initiated asthma inhalers before pandemic (cohorts 2014 and 2017) and during pandemic (cohort 2020).Methods: We performed retrospective inception cohort study using University of Groningen IADB.nl community pharmacy dispensing database. Individuals aged 16– 44 years who initiated inhaled asthma treatment in 2014, 2017, or 2020 were followed for 2 years. Treatment steps (1– 5) were based on the Global Initiative for Asthma (GINA) guideline. Primary outcomes included time to treatment step switch (step-up or step-down) and time to first oral prednisolone/prednisone, and were compared between cohorts using Cox regression models.Results: In 2014, 2017 and 2020, 1193, 960 and 730 patients initiated asthma inhalers, respectively. In all cohorts, more than half of the patients initiated treatment at the lowest step. During 2-year follow-up, fewer patients switched their treatment steps in 2020 when compared with 2014 (adjusted hazard ratio (aHR): 0.86 (95% confidence interval (CI): 0.76– 0.99). From 2014 to 2020, the likelihood of treatment stepping-down decreased over time, with a 21% in 2017 (aHR: 0.79 (0.68– 0.92)) and 24% in 2020 (aHR: 0.76 (0.64– 0.90)) compared to 2014, while the likelihood of stepping-up did not change significantly. The risk of taking oral prednisolone/prednisone was also significantly lower in 2020 (aHR: 0.76 (0.61– 0.94)).Conclusion: During the pandemic, fewer asthma patients switched treatment steps and took oral prednisolone/prednisone. Since 2014, fewer individuals stepping down medication, with a decrease of 21% in 2017 and 24% in 2020. Possible drivers include improved adherence, better asthma control, and increased telemedicine use—trends that predate and have been accelerated by the pandemic. Research incorporating clinical data is necessary to confirm these hypotheses.Keywords: asthma, COVID-19, inhaled medication, treatment step, trajectory, GINA
Authors: Zhou G, Mommers I, Schuilinga-Veninga CC, Bos JH, Oude Rengerink K, Pasmooij AMG, Mol PG, van Baarle D, de Bock GH, van Boven JF, Hak E
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7056051449
FWCI:
Cites:
Cited by:
Related to: