Medication dispensing patterns in England shifted during and after the COVID-19 pandemic, according to an analysis of national primary care dispensing data from more than 52 million people published in Nature Health.
The use of some treatments recovered to or exceeded pre-pandemic levels, including medications for cardiovascular disease and diabetes; the use of others, such as those for gastrointestinal and mental health conditions, remained lower. The findings suggest that linked medicines data could help researchers to monitor disrupted care pathways and inequalities in medication use.
Medication records offer a way to track how healthcare is delivered across society. When linked to individual-level information, these data can show differences in treatment patterns among children, older adults, deprived communities, and ethnic groups. They can also help to identify polypharmacy, when a person is dispensed five or more different medicines within a three-month period, a key marker of multiple long-term conditions.
Primary care medication
Reecha Sofat and colleagues analysed primary care medication dispensing in England between 1 November 2019 and 31 December 2024, covering 5.8 billion dispensed medications. Initiation of gastrointestinal and mental health medications declined and remained below pre-pandemic levels, whereas medications for cardiovascular disease and diabetes initially fell before recovering to, or in some cases exceeding, pre-pandemic levels.
The authors also found differences by sex, ethnicity, and socioeconomic deprivation. For example, Bangladeshi and Pakistani ethnic groups had higher dispensing rates for some medicines, including endocrine and eye medicines, reaching up to 2.5 times those of the British, Irish or other white background group by age 60. The most deprived individuals had rates up to twice those of the least deprived by age 40. By age 50, around 15% of the population was dispensed five or more concurrent medications, rising to 42% by age 70.
Pandemic-related disruption
The findings highlight pandemic-related disruption to clinical pathways and potential inequities in medication use, the authors conclude. They suggest that medicines intelligence — the use of linked data to track medicine use — could support pandemic recovery, future preparedness, and efforts to reduce health disparities.
Limitations of the research include that the data focus on primary care dispensing, do not establish causation, and exclude some medicines, including private care prescriptions, over-the-counter drugs, and many secondary-care medicines.
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