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Restrictions during the COVID-19 pandemic limited access to healthcare, which may have had a negative impact on drug prescribing. This study aimed to assess the effect of the COVID-19 pandemic on the initiation of antihypertensive drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Interrupted time series study using a segmented linear regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Swedish population assessed through linked national healthcare registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>720\u2009300 new users of antihypertensives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>March 2020, COVID-19 pandemic onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measures<\/jats:title>\n                    <jats:p>The change in the initiation of antihypertensives expressed as monthly cumulative incidence, stratified by age and sex. Data on dispensed prescriptions of diuretics, beta-blockers, calcium channel blockers, ACE inhibitors (ACEi) and angiotensin receptor blockers were extracted from the Swedish Prescribed Drug Register, from March 2018 to November 2021. Initiation (new use) was defined as having no previous dispensations before March 2019. Monthly cumulative incidence in March 2019\u2013November 2021 was calculated as the number of patients initiating each drug class in each month divided by the population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The start of the pandemic was associated with an immediate drop in the initiation of any antihypertensive, but no sustained effects were observed, as the incidence continued to increase in the postinterruption period by +0.02%\u2009each month in both sexes. The immediate drop was statistically significant for ACEi in both sexes and all antihypertensive classes except diuretics in patients &gt;65 years. \u0410 significant postintervention trend change was observed for initiation of diuretics (+0.013% overall), driven mainly by a significant increase in patients &gt;65 years. Similar findings were also observed for diuretics in females (+0.02%) and ACEi (+0.03%) in patients &gt;65 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The pandemic had an immediate negative short-term effect, but we found no major long-term negative influence of the COVID-19 pandemic on initiation of any type of antihypertensive drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082209","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T20:17:46Z","timestamp":1729109866000},"page":"e082209","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the COVID-19 pandemic on initiation of antihypertensive drugs in Sweden: an interrupted time series study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-872X","authenticated-orcid":false,"given":"Ana","family":"Tomas","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Toxicology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjorn","family":"Wettermark","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology & Social Pharmacy, Department of Pharmacy, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-5668","authenticated-orcid":false,"given":"Fredrik","family":"Nyberg","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8118-4988","authenticated-orcid":false,"given":"Mohammadhossein","family":"Hajiebrahimi","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology & Social Pharmacy, Department of Pharmacy, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"2025121400444862000_14.10.e082209.1","unstructured":"Worl Health Organization . 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