The impact of the COVID-19 pandemic on psychotropic prescribing: a systematic review
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Author(s)
Type
Journal Article
Abstract
Objectives: The global prevalence of mental health disorders has risen significantly since the beginning of the COVID-19 pandemic. The pandemic has additionally caused disruption to mental health services, leading to a shift from in-person to remote service delivery. Given its long-term impact, it has become critical to evaluate whether changes in health delivery during the pandemic have had an effect on prescribing patterns for commonly prescribed psychotropic drugs. This study aims to assess the impact of the COVID-19 pandemic on changes in psychotropic prescribing patterns in adults, as well as differences in prescribing in different healthcare delivery approaches across various geographic contexts.
Design and eligibility requirements: Systematic review of cohort, interrupted time-series and cross-sectional studies examining prescribing trends for at least one commonly prescribed psychotropic drug during and after COVID-19 in accessing care remotely or face-to-face between January 1st, 2020 to June 17th, 2022.
Data sources: MEDLINE, EMBASE, CINAHL, HMIC, and PsycINFO databases were searched in addition to citation chaining of relevant reviews.
Extraction and analysis: Study screening, data extraction and quality assessment were completed by two independent reviewers. The PECO strategy was used to devise the systematic review and findings were synthesised narratively.
Results: 16 studies were eligible for inclusion. Studies documenting changes in psychotropic prescribing trends provided very conflicting findings. There were no stark differences in prescribing outcomes between different healthcare delivery methods (i.e., face-to-face consultations vs remote consultations). A noteworthy finding was that the prescribing rate of benzodiazepines was higher in women than men. No particular trends were observed for the prescription rates of hypnotics, antidepressants or antipsychotics.
Conclusions: Findings support both mixed trends in the prescription of psychotropic medications in a range of settings, hindering conclusive statements on COVID-19's impact on prescribing. In areas where remote consultations are in use, more comprehensive research is required to assess the safety of prescribing in these settings to inform public health policy and assess if the observed trends in our systematic review persist over time (given the increased consideration of remote and telehealth care in delivering services), particularly the safe and effective deployment of these services.
Design and eligibility requirements: Systematic review of cohort, interrupted time-series and cross-sectional studies examining prescribing trends for at least one commonly prescribed psychotropic drug during and after COVID-19 in accessing care remotely or face-to-face between January 1st, 2020 to June 17th, 2022.
Data sources: MEDLINE, EMBASE, CINAHL, HMIC, and PsycINFO databases were searched in addition to citation chaining of relevant reviews.
Extraction and analysis: Study screening, data extraction and quality assessment were completed by two independent reviewers. The PECO strategy was used to devise the systematic review and findings were synthesised narratively.
Results: 16 studies were eligible for inclusion. Studies documenting changes in psychotropic prescribing trends provided very conflicting findings. There were no stark differences in prescribing outcomes between different healthcare delivery methods (i.e., face-to-face consultations vs remote consultations). A noteworthy finding was that the prescribing rate of benzodiazepines was higher in women than men. No particular trends were observed for the prescription rates of hypnotics, antidepressants or antipsychotics.
Conclusions: Findings support both mixed trends in the prescription of psychotropic medications in a range of settings, hindering conclusive statements on COVID-19's impact on prescribing. In areas where remote consultations are in use, more comprehensive research is required to assess the safety of prescribing in these settings to inform public health policy and assess if the observed trends in our systematic review persist over time (given the increased consideration of remote and telehealth care in delivering services), particularly the safe and effective deployment of these services.
Date Issued
2024-09
Date Acceptance
2024-08-27
Citation
BMJ Open, 2024, 14 (9)
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Volume
14
Issue
9
Copyright Statement
© Author(s) (or their
employer(s)) 2024. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
employer(s)) 2024. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
License URL
Identifier
https://bmjopen.bmj.com/content/14/9/e076791
Publication Status
Published
Article Number
e076791
Date Publish Online
2024-09-25