(C-101) A time-trend analysis of psychotropic drug prescription patterns in a Peruvian inpatient population during the COVID-19 pandemic

Background: The COVID-19 pandemic disrupted healthcare systems, impacting psychiatric care for hospitalized patients. Increased psychological distress and shifts in clinical priorities may have influenced patterns of psychotropic drug prescribing. Understanding these trends is essential to evaluating how inpatient psychiatric care adapted during this challenging time.

Objectives: This study aims to examine the prescribing pattern and trends of psychotropic drugs in a consultation-liaison psychiatry unit at a Peruvian general hospital during the COVID-19 pandemic.

Methods: We conducted a time-trend analysis of 27 psychotropic drugs, coded using the Anatomic Therapeutic Chemical (ATC) classification system, based on medical records of 4,912 inpatients from the consultation-liaison psychiatry unit at Guillermo Almenara Irigoyen National Hospital (Peru) between 2020 and 2022. Prescription rates per 1,000 patients per year (RPY1000) were calculated. A binary logistic regression, with year as an ordinal predictor, assessed prescription trends. Odds ratios (OR) with 95% confidence intervals (CI) were reported, and model fit was evaluated using the Hosmer-Lemeshow test.

Results: In the total population (54.7% were female and 53.3% were aged 18-60 yo), almost half of the patient population received at least one psychotropic drug (40.17%). The medication classes with the highest RPY1000 were antidepressants (246.4, and 209.9 in 2020 and 2021, respectively) and anxiolytics (183.4 in 2022). Sertraline (N06AB06) and Mirtazapine (N06AX11) were the most frequently prescribed antidepressants; sodium valproate (N03AG01) and carbamazepine (N03AF01) were the most commonly used mood stabilizers; alprazolam (N05BA12) and clonazepam (N03AE01) were the predominant anxiolytics; and haloperidol was the most frequently prescribed antipsychotic during the study period. Finally, we observed a decreased trend over time (2020 - 2022) in the prescription of the total antipsychotics (OR=0.84; 95% CI=0.76-0.93; p< 0.001).

Conclusions: The study found significant use of psychotropic medications, especially antidepressants and anxiolytics, in this Peruvian consultation-liaison psychiatry unit during the COVID-19 pandemic. However, overall psychotropic drug utilization decreased during this period, which may indicate changes in clinical practice in response to the pandemic.