Article Figures & Data
Figures
- Figure 1. Weekly counts of COVID-19 consultations and COVID-19 consultations with ICS prescriptions. The consultations with ICS prescription follow the scale on the right side of the figure. This scale is chosen such that frequency patterns can be assessed simultaneously. The intervention date was 2 November 2021 (the day the NHG published its updated guideline) with regard to budesonide and is marked with the vertical line
- Figure 2. The observed weekly prescription rate (ratio of COVID-19 cases with ICS prescription per COVID-19 consult), along with the trend and seasonal effect. The counterfactual line is formed by continuing the trend estimated from the period before the guideline revision. The vertical line denotes the day of the guideline revision, 11 November 2021
Tables
- Table 1. Baseline characteristics of patients who had at least one COVID-19 consultation during the study period
Prescribed Not prescribed Characteristic Before update, N=526 After update, N=1208 Overall, N=1709 Overall, N=129 773 Male sex, n (%) 193 (36.7) 441 (36.5) 627 (36.7) 59 996 (46.2) Mean age, years (SD) 51.5 (17.2) 48.7 (19.9) 49.6 (19.2) 36.8 (20.4) Target NHG advice (age ≥65 years or age ≥50 years with comorbiditya), n (%) 225 (42.8) 475 (39.3) 689 (40.3) 17 637 (13.6) Number of episodes, mean (SD) 2.07 (0.8) 1.50 (0.7) 1.66 (0.8) 1.24 (0.5) Any of the following comorbidities, n (%) 320 (60.8) 718 (59.4) 1019 (59.6) 17 556 (13.5) Asthma 251 (47.7) 575 (47.6) 808 (47.3) 8464 (6.5) COPD 42 (8.0) 109 (9.0) 151 (8.8) 1412 (1.1) Cardiovascular disease 71 (13.5) 170 (14.1) 239 (14.0) 6837 (5.3) Diabetes 4 (0.8) 7 (0.6) 11 (0.6) 402 (0.3) Chronic kidney damage 31 (5.9) 67 (5.5) 98 (5.7) 2692 (2.1) Liver cirrhosis 11 (2.1) 13 (1.1) 23 (1.3) 674 (0.5) Age and whether the patient is targeted by the NHG advice is computed at the moment of their first COVID-19 episode. There were 25 patients who were prescribed ICSs both before and after guideline update. These are included in both column two and three.
↵a Comorbidities are asthma, COPD, cardiovascular disease, diabetes, chronic kidney damage, or liver cirrhosis.
- Table 2. Estimated incidence risk ratios for quasi-Poisson model for the weekly prescription rate
Variable IRR 95% CI p-value Weeks after study start 1.00 1.00 to 1.01 0.06 After guideline revision (indicator) 0.47 0.32 to 0.69 <0.001 Weeks after guideline revision 1.01 0.99 to 1.02 0.31 Q1 (indicator) 0.70 0.58 to 0.84 <0.001 Q2 (indicator) 1.01 0.81 to 1.27 0.91 Q3 (indicator) 0.75 0.59 to 0.96 0.02 Weeks after study start represents the trend before guideline revision. After guideline revision (indicator) represents the immediate effect of guideline revision and the row for the weeks after guideline revision represents the trend change with respect to the period before revision. Q1, Q2, and Q3 model seasonal effects in the first, second, and third quarter of the year with respect to the fourth quarter.
Autocorrelation has been accounted for by adjusting the confidence interval and p-value using the Newey West method.
CI = confidence interval. IRR = incidence risk ratio.
Supplementary Data
- vanE_10.3399BJGPO.2024.0135_supp.docx -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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