scholarly journals Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis

2021 ◽  
Vol 18 (24) ◽  
pp. 13253
Author(s):  
Ippazio Cosimo Antonazzo ◽  
Carla Fornari ◽  
Sandy Maumus-Robert ◽  
Eleonora Cei ◽  
Olga Paoletti ◽  
...  
Keyword(s):  
Time Series ◽  
General Population ◽  
Time Series Analysis ◽  
Virus Transmission ◽  
Interrupted Time Series ◽  
Population Based ◽  
Administrative Database ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Continuous Care

Background: In 2020, during the COVID-19 pandemic, Italy implemented two national lockdowns aimed at reducing virus transmission. We assessed whether these lockdowns affected anti-seizure medication (ASM) use and epilepsy-related access to emergency departments (ED) in the general population. Methods: We performed a population-based study using the healthcare administrative database of Tuscany. We defined the weekly time series of prevalence and incidence of ASM, along with the incidence of epilepsy-related ED access from 1 January 2018 to 27 December 2020 in the general population. An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Results: Compared to pre-lockdown, we observed a relevant reduction of ASM incidence (0.65; 95% Confidence Intervals: 0.59–0.72) and ED access (0.72; 0.64–0.82), and a slight decrease of ASM prevalence (0.95; 0.94–0.96). During the post-lockdown the ASM incidence reported higher values compared to pre-lockdown, whereas ASM prevalence and ED access remained lower. Results also indicate a lower impact of the second lockdown for both ASM prevalence (0.97; 0.96–0.98) and incidence (0.89; 0.80–0.99). Conclusion: The lockdowns implemented during the COVID-19 outbreaks significantly affected ASM use and epilepsy-related ED access. The potential consequences of these phenomenon are still unknown, although an increased incidence of epilepsy-related symptoms after the first lockdown has been observed. These findings emphasize the need of ensuring continuous care of epileptic patients in stressful conditions such as the COVID-19 pandemic.

scholarly journals Changes in benzodiazepine use in the French general population after November 2015 terrorist attacks in Paris: an interrupted time series analysis of the national CONSTANCES cohort

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e044891
Author(s):  
Clement Gouraud ◽  
Guillaume Airagnes ◽  
Sofiane Kab ◽  
Emilie Courtin ◽  
Marcel Goldberg ◽  
...  
Keyword(s):  
Higher Education ◽  
At Risk ◽  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Population Based ◽  
Terrorist Attacks ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Benzodiazepine Use

ObjectivesTo determine whether the terrorist attacks occurring in Paris on November 2015 have changed benzodiazepine use in the French population.DesignInterrupted time series analysis.SettingNational population-based cohort.Participants90 258 individuals included in the population-based CONSTANCES cohort from 2012 to 2017.Outcome measuresBenzodiazepine use was evaluated according to two different indicators using objective data from administrative registries: weekly number of individuals with a benzodiazepine delivered prescriptions (BDP) and weekly number of defined daily dose (DDD). Two sets of analyses were performed according to sex and age (≤50 vs >50). Education, income and area of residence were additional stratification variables to search for at-risk subgroups.ResultsAmong women, those with younger age (incidence rate ratios (IRR)=1.18; 95% CI=1.05 to 1.32 for BDP; IRR=1.14; 95% CI=1.03 to 1.27 for DDD), higher education (IRR=1.23; 95% CI=1.03 to 1.46 for BDP; IRR=1.23; 95% CI=1.01 to 1.51 for DDD) and living in Paris (IRR=1.27; 95% CI=1.05 to 1.54 for BDP) presented increased risks for benzodiazepine use. Among participants under 50, an overall increase in benzodiazepine use was identified (IRR=1.14; 95% CI=1.02 to 1.28 for BDP and IRR=1.12; 95% CI=1.01 to 1.25 for DDD) and in several strata. In addition to women, those with higher education (IRR=1.22; 95% CI=1.02 to 1.47 for BDP), lower income (IRR=1.17; 95% CI=1.02 to 1.35 for BDP) and not Paris residents (IRR=1.13; 95% CI=1.02 to 1.26 for BDP and IRR=1.13; 95% CI=1.03 to 1.26 for DDD) presented increased risks for benzodiazepine use.ConclusionTerrorist attacks might increase benzodiazepine use at a population level, with at-risk subgroups being particularly concerned. Information and prevention strategies are needed to provide appropriate care after such events.

scholarly journals Antimicrobial stewardship during the COVID-19 epidemic: population-based cohort study and interrupted time series analysis in the United Kingdom

2021 ◽  
pp. BJGP.2020.1051
Author(s):  
Emma Rezel-Potts ◽  
Veline L'Esperance ◽  
Martin Gullifiord
Keyword(s):  
Time Series ◽  
Cohort Study ◽  
Time Series Analysis ◽  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Population Based ◽  
Antibiotic Prescribing ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Tract Infections

Background. The COVID-19 pandemic has altered the context for antimicrobial stewardship in primary care. Aim: To assess the effect of the pandemic on antibiotic prescribing, accounting for changes in consultations for respiratory and urinary tract infections (RTIs/UTIs). Design and Setting: Population-based cohort study using the UK Clinical Practice Research Datalink (CPRD) (January 2017 to September 2020). Method: Interrupted time series analysis evaluated changes in antibiotic prescribing and RTI/UTI consultations adjusting for age, gender, season and secular trends. We assessed the proportion of COVID-19 episodes associated with antibiotic prescribing. Results: There were 253,655 registered patients in 2017 and 232,218 in 2020 with 559,461 antibiotic prescriptions, 216,110 RTI consultations and 36,402 UTI consultations. Compared to pre-pandemic months, March 2020 was associated with higher prescribing (adjusted rate ratio 1.13; 95% confidence interval 1.11 to 1.16). Prescribing fell below predicted rates between April and August 2020, reaching a minimum in May (0.73, 0.71 to 0.75). Pandemic months were associated with lower rates of RTI/UTI consultations, particularly in April for RTIs (0.23; 0.22 to 0.25). There were small reductions in the proportion of RTI consultations with antibiotic prescribed and no reduction for UTIs. Among 25,889 COVID-19 patients, 2,942 (11%) had antibiotics within a COVID-19 episode. Conclusion: Pandemic months were initially associated with increased antibiotic prescribing which then fell below expected levels during the national lockdown. Findings are reassuring that antibiotic stewardship priorities have not been neglected due to COVID-19. Research is required into the effects of reduced RTI/UTI consultations on incidence of serious bacterial infection.

scholarly journals Association between tobacco plain packaging and Quitline calls: a population‐based, interrupted time‐series analysis

2014 ◽  
Vol 200 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Jane M Young ◽  
Ingrid Stacey ◽  
Timothy A Dobbins ◽  
Sally Dunlop ◽  
Anita L Dessaix ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Population Based ◽  
Interrupted Time Series Analysis ◽  
Plain Packaging ◽  
Series Analysis

scholarly journals Does admission prevalence change after reconfiguration of inpatient services? An interrupted time series analysis of the impact of reconfiguration in five centres

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanne Martin ◽  
Edwin Amalraj Raja ◽  
Steve Turner
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Emergency Admission ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Emergency Admissions ◽  
Series Analysis ◽  
Inpatient Services ◽  
The Impact ◽  
Admission Prevalence

Abstract Background Service reconfiguration of inpatient services in a hospital includes complete and partial closure of all emergency inpatient facilities. The “natural experiment” of service reconfiguration may give insight into drivers for emergency admissions to hospital. This study addressed the question does the prevalence of emergency admission to hospital for children change after reconfiguration of inpatient services? Methods There were five service reconfigurations in Scottish hospitals between 2004 and 2018 where emergency admissions to one “reconfigured” hospital were halted (permanently or temporarily) and directed to a second “adjacent” hospital. The number of emergency admissions (standardised to /1000 children in the regional population) per month to the “reconfigured” and “adjacent” hospitals was obtained for five years prior to reconfiguration and up to five years afterwards. An interrupted time series analysis considered the association between reconfiguration and admissions across pairs comprised of “reconfigured” and “adjacent” hospitals, with adjustment for seasonality and an overall rising trend in admissions. Results Of the five episodes of reconfiguration, two were immediate closure, two involved closure only to overnight admissions and one with overnight closure for a period and then closure. In “reconfigured” hospitals there was an average fall of 117 admissions/month [95% CI 78, 156] in the year after reconfiguration compared to the year before, and in “adjacent” hospitals admissions rose by 82/month [32, 131]. Across paired reconfigured and adjacent hospitals, in the months post reconfiguration, the overall number of admissions to one hospital pair slowed, in another pair admissions accelerated, and admission prevalence was unchanged in three pairs. After reconfiguration in one hospital, there was a rise in admissions to a third hospital which was closer than the named “adjacent” hospital. Conclusions There are diverse outcomes for the number of emergency admissions post reconfiguration of inpatient facilities. Factors including resources placed in the community after local reconfiguration, distance to the “adjacent” hospital and local deprivation may be important drivers for admission pathways after reconfiguration. Policy makers considering reconfiguration might consider a number of factors which may be important determinants of admissions post reconfiguration.

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