Prescription rates in different groups of outpatients with covid-19 and other acute respiratory infections: comparative observational study based on German routine data.

Abstract

Objectives: To identify and quantify prescriptions after a covid-19 infection compared with other acute respiratory infections in previously healthy patients and those with chronic disease.

Design: Comparative observational study based on German routine data.

Setting: Ambulatory care of all residents in Germany with statutory health insurance (88% of the German population).

Participants: Adults receiving a diagnosis of covid-19 or an acute respiratory infection between the fourth quarter of 2020 and the second quarter of 2021 who had rarely (70 797 and 173 822 with covid-19 and acute respiratory infection, respectively) or frequently (900 593 and 1 755 691, respectively) accessed outpatient medical care in the past.

Main outcome measures: Difference in differences in the proportion of prescriptions of relevant drugs before and one year after infection.

Results: In patients who used the healthcare system less frequently before their covid-19 infection than afterwards, increases in prescription rates for antidiabetics (difference in differences 0.23%, P=0.007), antithrombotics (0.71%, P=0.02), and cardiovascular drugs like beta blockers (0.25%, P=0.03) were observed compared with patients with other acute respiratory infections. One year after infection, the difference in antidiabetic prescription rates was highest. Although a peak in antihypertensive prescription rates was observed six months after infection, antithrombotics were predominantly prescribed during the acute phase. Conversely, patients who had already used the healthcare system on a regular basis before their infection showed no significant long term increases in prescription rates across the drug groups analysed.

Conclusions: This study supports findings that diseases such as diabetes and cardiovascular disease are more prevalent after covid-19 than after other acute respiratory infections. Because the effect is apparent in real world data, future societal implications should be considered, including increased disease burden and growing demand for medical care owing to the increasing need for drugs.