Epidemiology and Health

COVID-19: Original Article

Influence of practice location on prescribing, diabetes care, and colorectal cancer screening among Czech general practitioners during the COVID-19 pandemic: Jan Bělobrádek, Luděk Šídlo, Tom Philipp; Epidemiol Health. 2024;46:e2024033. Published online February 23, 2024; DOI: https://doi.org/10.4178/epih.e2024033

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices.
METHODS
We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology.
RESULTS
We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs).
CONCLUSIONS
Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.; Summary

Key Message
Primary care in Czechia has effectively adapted to the changes brought about by the COVID-19 pandemic. Minimal impact was observed in prescribtions and diabetic patient care. There was a significant decline in colorectal cancer screening, with a slow restitution after the pandemic subsided. Rural GPs consistently provided in-house treatment and have higher shares of both prescribing and diabetes care, as well as performing more COVID-19 specific procedures.

Brief Communication

Prescribing patterns for attention deficit hyperactivity disorder medications among children and adolescents in Korea, 2007-2011: Inmyung Song, Ju-Young Shin; Epidemiol Health. 2016;38:e2016045. Published online October 26, 2016; DOI: https://doi.org/10.4178/epih.e2016045

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15 Web of Science
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Abstract Summary PDF

Abstract

OBJECTIVES
This study analyzed the prevalence of attention deficit hyperactivity disorder (ADHD) medication use among children and adolescents in Korea between January 1, 2007 and December 31, 2011.

METHODS

Using the Korea National Health Insurance claims database, we identified patients between one and 17 years of age who had at least one medical claim for the diagnosis of ADHD (International Classification of Diseases, 10th revision: F90.0). The annual prevalence of ADHD diagnoses was calculated, using national census data from Statistics Korea on the population aged between one and 17 years as the denominator. The prevalence was age-standardized using the 2010 population as the standard population. The number of patients who were treated with methylphenidate and/or atomoxetine and the prevalence of total patients with ADHD that were treated with either drug were also calculated for each year. All analyses were stratified according to gender and age group (1-5 years, 6-12 years, and 13-17 years).

RESULTS

The number of patients diagnosed with ADHD increased from 72,704 persons (0.71%) in 2007 to 85,468 persons (0.93%) in 2011. The annual age-standardized prevalence of ADHD diagnoses increased from 0.67% in 2007 to 0.94% in 2011. The prevalence of methylphenidate use among children and adolescents with ADHD decreased from 73.91% in 2007 to 70.33% in 2011, whereas that of atomoxetine use increased from 5.77% in 2009 to 13.09% in 2011.

CONCLUSIONS

While methylphenidate remains the most commonly prescribed ADHD drug, the use of atomoxetine has increased.

Summary

Korean summary
전국민보험자료를 분석한 본 연구에 따르면 한국의 17세 이하 소아인구에서 주의력결핍과다행동장애(ADHD) 진단을 받은 환자의 비율이 2007년 0.71%에서 2011년 0.93%로 증가하였다. ADHD 진단받은 환자 중 메틸페니데이트를 처방받은 환자 비율은 2007년 73.91%에서 2011년 70.33%로 감소한 반면, 아토목세틴을 처방받은 환자 비율을 2009년 5.77%에서 2011년 13.09%로 증가하였다

Citations

Citations to this article as recorded by

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