Psychiatric Medication Adherence in the United States Before and During the COVID-19 Pandemic.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-10-01 DOI:10.1002/pds.70229

Rebecca C Rossom, Hsueh-Han Yeh, Robert B Penfold, Gregory E Simon, Stephanie A Hooker, Lisiyu Ma, Lisa Miller-Matero, Ashli Owen-Smith, Brian K Ahmedani

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Abstract

Objective: The COVID-19 pandemic caused disruptions in in-person mental health (MH) care and a rapid uptake of virtual MH care, but there is little research on the impacts of this on patients' ability to continue their MH medications. This study used population-level data to examine the impact of the pandemic on MH medication nonadherence.

Methods: This retrospective study used electronic health record and claims data to identify 149,977 patients with MH diagnoses at three U.S. health systems who filled at least one MH medication in the 9 months before and after 3/14/2020. The primary outcome was nonadherence to MH medications (i.e., a disruption in coverage ≥ 25%) during the pandemic.

Results: Pre-pandemic, 39% of patients had MH medication nonadherence, while 35% had nonadherence during the pandemic. Nonadherence during the pandemic improved for nearly all patient subgroups, with the exception of Black patients, for whom MH medication nonadherence increased from 47% to 49%. Asian, Black, and Hispanic patients were less adherent to MH medications during the pandemic than White patients, and patients with lower education or income were less adherent than patients with higher education or income. Non-rural patients were less adherent to MH medication than rural patients.

Conclusions: Adherence to MH medications improved during the pandemic for all subgroups except Black patients. Despite these improvements, disparities in MH medication adherence persisted for Asian, Black, and Hispanic patients and for patients with lower education or income, suggesting these populations may need additional outreach and support.

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COVID-19大流行之前和期间美国精神科药物依从性

目的：2019冠状病毒病（COVID-19）大流行导致面对面精神卫生（MH）护理中断，虚拟MH护理迅速普及，但这对患者继续使用MH药物能力的影响研究甚少。本研究使用人口水平的数据来检查大流行对MH药物依从性的影响。方法：本回顾性研究使用电子健康记录和索赔数据，确定了在2020年3月14日之前和之后的9个月内在三个美国卫生系统中诊断为MH的149,977例患者。主要结局是大流行期间对MH药物的不依从性（即覆盖率中断≥25%）。结果：大流行前，39%的患者有MH药物不依从，而大流行期间有35%的患者不依从。在大流行期间，几乎所有患者亚组的不依从性都有所改善，但黑人患者除外，他们的MH药物不依从性从47%增加到49%。亚洲、黑人和西班牙裔患者在大流行期间对MH药物的依从性低于白人患者，教育程度或收入较低的患者比教育程度或收入较高的患者更少依从。非农村患者对MH药物的依从性低于农村患者。结论：大流行期间，除黑人患者外，所有亚组患者对MH药物的依从性均有所改善。尽管有这些改善，但亚洲、黑人和西班牙裔患者以及教育程度或收入较低的患者在MH药物依从性方面的差异仍然存在，这表明这些人群可能需要额外的推广和支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.