Robert Fletcher of the University of Cambridge, Health Data Research UK and The George Institute, and study co-lead says:

“Levels of obesity in England have worsened since the pandemic, with nearly one in three people now affected.

“We’re also seeing large disparities across the country: the percentage of adults affected by obesity in northeast England is six times higher than in central London. Differences on this scale are rarely seen in other areas of public health. The rise in new cases among young adults of childbearing age is especially concerning. Beyond the implications for their own long-term health, obesity is associated with infertility, adverse pregnancy outcomes, and child obesity, which may perpetuate intergenerational cycles of health inequality.”

Key findings:

Obesity is rising: Rates of new obesity cases increased overall by 4% in 2025 compared with before the COVID-19 pandemic.

Young adults hit hardest: The largest increases over time were seen in younger adults. Rates of new obesity cases rose by almost 20% in those aged 30-39, and by 16% in those aged 20-29, while rates fell among adults aged 60-79.

Risk rises with deprivation: Over the study period, rates of new obesity cases were 35% higher for people with the highest socioeconomic deprivation (those with the lowest incomes, highest unemployment, and poorest housing) compared with people with the lowest socioeconomic deprivation. The gap was wider still for women, where new cases were 54% higher among the most deprived, and widest for Asian women, at 94% higher.

Ethnicity and deprivation compound: The percentage of people living with obesity ranged from 4% among the most affluent White men aged 18–19 to 66% among the most socioeconomically deprived Black women aged 60–69 – nearly double the figure for the least-deprived White women of the same age.

Large geographical differences: The percentage of people affected by obesity in some areas of northeast England (48%) was nearly six times higher than that seen in the most affluent parts of central London (8.5%). The steepest increases over time were seen in areas with the lowest GDP per capita.

The person-level data analysed in this study has all direct identifiers such as names and NHS numbers removed before researchers access the data, which is then only accessible within NHS England’s Secure Data Environment. The data is only accessible by approved researchers working on approved, COVID-19 related research projects.

The researchers’ definition for obesity was a recorded body-mass index (BMI) of 30 or above, or a clinician’s diagnosis of obesity in a person’s health records. Their findings from this electronic health record study correspond well with the NHS Health Study for England, which samples households across the country, giving confidence in the extra depth of the insights this study is able to provide.

They looked at rates of new cases of obesity (incidence) and the percentage of people with obesity (prevalence) in the general population, as well as differences across sociodemographic groups and geographical regions.

Obesity is now more common than hypertension (high blood pressure) in the UK, and nearly three times as common as smoking. It is a chronic, complex disease linked with a whole host of conditions, including heart disease, stroke, cancer, diabetes, and kidney failure. As well as affecting individuals’ mental wellbeing, and placing growing pressure on both the healthcare system and the economy. These findings highlight the scale and urgency of the obesity crisis, and how it has worsened since the COVID-19 pandemic.

GLP-1 receptor agonist drugs, like Ozempic/Wegovy and Mounjaro, are known to be effective in managing obesity and are being more widely prescribed and used. The study did not set out to examine their impact.

“We don’t see any obvious reduction in obesity in our data following the introduction of GLP-1 receptor agonists, at least not within the current study period,” says Robert Fletcher. “However, the drugs on their own are unlikely to be the answer. At present, the majority are privately prescribed and the jabs are expensive, which poses a barrier for people from disadvantaged backgrounds. We need deep-seated change to the many social and economic factors that drive obesity in the first place.”

Naveed Sattar, one of the co-authors, Professor of Cardiometabolic Medicine at the University of Glasgow and Chair of the Obesity Health Care Goals Programme, agrees:

“Obesity is not primarily about will power. These new, powerful data indicate that those most at risk frequently reside in the most obesogenic environments and likely have the least agency to withstand such environments. To achieve lasting change, the UK must expand access to new treatments faster but also fundamentally reshape food and activity environments so that healthier choices occur with minimal conscious effort. Failure to act will drive further rises in multimorbidity and human suffering, with profound consequences for the NHS and the wider economy.”

Study co-lead Angela Wood, Professor at the University of Cambridge and Associate Director at the British Heart Foundation Data Science Centre, says:

“The COVID-19 pandemic has had a lasting impact on health and lifestyle behaviours. By analysing electronic health records from the entire adult population of England before, during, and after the pandemic, we have generated the most comprehensive evidence to date on how obesity risk and burden are increasingly diverging across multiple dimensions of inequality. These findings underscore the critical importance of secure access to whole-population health data to enable research, surveillance, and timely action to address widening health inequalities.”

The study, funded by the Wellcome Trust, Health Data Research UK, the British Heart Foundation, the National Institute for Health and Care Research Cambridge Biomedical Research Centre, the Cambridge British Heart Foundation Centre of Research Excellence, has been published in The Lancet Diabetes & Endocrinology.

The post Obesity inequalities in England have widened since COVID-19 – with steepest increases in new cases in young adults appeared first on Pharmacy Update Online.

The findings were published on March 9, 2026 in the CMAJ/Canadian Medical Association Journal.

“Our findings may reflect improved recognition and treatment of ADHD in adulthood; however, the speed and scale of this growth also raises important questions about how diagnoses are being made, and if this prescribing is always appropriate,” said Dr. Tara Gomes, program director of the Ontario Drug Policy Research Network at St. Michael’s Hospital, Unity Health Toronto and an ICES scientist, Toronto, Ontario.

As background, the researchers noted that, historically, stimulants have been prescribed mainly for pediatric cases of ADHD and some other conditions. But in the past 20 years, ADHD diagnoses and stimulant prescriptions have increased among adults, and data shows that this change accelerated after the start of the pandemic.

“We sought to examine patterns of stimulants dispensed to adults in Ontario and characterize adults who initiated such therapy before and during the pandemic,” the authors said.

The investigators used a regional database to identify monthly rates of new stimulant dispensations among adults in Ontario between January 2016 and June 2024

They found that among 327,053 adults who initiated stimulant therapy, the median age was 31 years and 55.4% were female.

When compared with stimulant prescribing before the COVID-19 pandemic, new adult users during the pandemic were more likely to be aged 25 to 34 years (26.5% v. 32.8%) and female (48.0% v. 59.0%). And the drugs were less likely to be prescribed by psychiatrists (25.5% v. 18.0%).

The rate of new stimulant dispensations rose from 0.16 to 0.44 new monthly dispensations per 1000 people between January 2016 and June 2024.

“Many of these findings are consistent with trends in stimulant prescribing observed globally in the post-pandemic era and are likely influenced by greater awareness of adult ADHD and improved access to care following a historical pattern of underdiagnosis of ADHD in adulthood — particularly among women,” said coauthor Dr. Mina Tadrous, associate professor, Leslie Dan Faculty of Pharmacy, University of Toronto. “However, the rising impact of social media influencers on ADHD awareness in young adults, as well as the rapid evolution of virtual health services that support online assessments and treatment, may also be contributing to misdiagnoses and potential harm.”

The authors concluded, “In Ontario, rates of new prescriptions for stimulants dispensed to adults accelerated rapidly during the COVID-19 pandemic. Monitoring and evaluation are needed to ensure appropriateness of use and safeguard against potential harms.”

The post Adult ADHD medication prescriptions more than doubled since start of COVID-19 pandemic appeared first on Pharmacy Update Online.

Depression is the most severely impacted, with almost a third fewer diagnoses than expected compared with pre-pandemic trends.

The King’s College London study is the first to evaluate whether diagnosis rates have recovered after emerging from the pandemic. Published today in the British Medical Journal (BMJ), it uses anonymised data from over 29 million people in England.

The pandemic had an unprecedented impact on healthcare systems around the world, leading to abrupt decreases in diagnosis rates for a wide range of diseases.

Of the 19 major conditions analysed, diagnoses of depression were 27.7% lower than expected compared with pre-pandemic trends. Diagnoses were also lower than expected for asthma (16.4%), chronic obstructive pulmonary disease (COPD, 15.8%) and osteoporosis (11.5%).

The study also identified differences in how diagnosis rates recovered across ethnic and socioeconomic groups. While dementia diagnoses recovered to pre-pandemic levels for individuals of white ethnicity and those living in less deprived areas, they remained lower than expected among other ethnic groups and in more deprived communities.

Co-author Professor Sam Norton, Professor of Medical Statistics at King’s College London, said: “The deficits in depression diagnoses were particularly striking and somewhat puzzling. After an initial decrease during the early pandemic, diagnosis rates partially recovered by late 2021, but have declined markedly since 2022. This pattern was most evident among younger adults aged 20 to 39 years, and among individuals of white or mixed ethnicity.

“This is difficult to reconcile with other indicators of mental health need. Disability benefit claims for mental health conditions have increased substantially over the same period, suggesting these declining diagnosis rates may not reflect improving mental health.”

Diagnosis rates may be influenced by increasing pressures on the NHS, meaning it is taking longer for people to be formally diagnosed. It is also possible that more people are accessing mental health support without receiving a formal diagnosis of depression. Following a national drive to expand access to psychological therapies, referrals to NHS Talking Therapies services increased by nearly two-thirds between 2013 and 2024, with self-referrals accounting for almost 70% of all referrals.

The team also suggest that pandemic-related disruption could be behind the fall in diagnoses for asthma, COPD and osteoporosis. Backlogs in diagnostic testing for these conditions during the pandemic is likely to be a key factor, and the NHS has identified this as a priority area for improvement.

Further analysis revealed that chronic kidney disease (CKD) diagnoses have increased by 34.8% compared to expected levels.

Lead author Dr Mark Russell, consultant rheumatologist and epidemiologist at King’s College London, said: “The rise in CKD diagnoses may reflect increased testing and greater awareness following guideline changes and the introduction of new treatments.

“It is also possible that the pandemic itself has contributed to an increase in CKD, either through the direct effects of Covid-19 infection or through delays in diagnosing related conditions such as diabetes.”

The research team used OpenSAFELY, a highly secure and anonymised NHS data platform, to analyse disease trends for 29 million people between April 2016 and November 2024.

Dr Russell added: “This study highlights the incredible health data resources available within the NHS and demonstrates how real-time, anonymised data could be used safely and securely, without any individual patient data ever leaving the NHS system, to transform disease monitoring, enabling earlier identification of inequities and informing how care is delivered.”

Notes to Editors

The OpenSAFELY platform is principally funded by grants from NHS England, the Wellcome Trust, and the Medical Research Council.

The post Diagnoses of major conditions failing to recover since the pandemic appeared first on Pharmacy Update Online.

The National Institute on Aging-funded study offers valuable insights into the role of telehealth in home healthcare, a rapidly expanding sector. As the population ages and seeks alternatives to nursing homes, this field is expected to grow by 10 percent annually.

The survey’s findings spotlight the urgent need for policy considerations from the Centers for Medicare & Medicaid Services, which has not reimbursed home healthcare agencies for telehealth services, even during the pandemic.

Conducted from October 2023 to November 2024, the study queried 791 home healthcare agencies, with a response rate of 37 percent. It focused on businesses that served a significant portion of dementia patients, averaging 33 percent of their clientele. The results revealed that only 23 percent of home healthcare agencies had adopted telehealth by 2019. However, that number surged to 65 percent by 2021, primarily driven by the implementation of virtual visits to mitigate disease transmission and address staffing and equipment shortages during the COVID-19 pandemic. Nevertheless, 19 percent of adopting agencies had discontinued telehealth by 2024. The reasons cited for this included a lack of Medicare reimbursement and concerns about the suitability of telehealth for the home healthcare of older, less tech-savvy patients.

“This study is the first to provide a comprehensive national picture of telehealth’s trajectory in home healthcare,” said corresponding author Dana B. Mukamel, UC Irvine Distinguished Professor of medicine. “Our findings suggest that without [Centers for Medicare & Medicaid Services] reimbursement, many agencies may abandon telehealth, potentially missing opportunities to improve care and manage costs as home health demand skyrockets.”

The survey revealed that 33 percent of home healthcare agencies never adopted telehealth, even during the pandemic, often believing it inappropriate for the sector’s hands-on model. Virtual visits saw the largest adoption spike in 2020 (21.1 percent), but 22 percent of users had discontinued them by about 2022. Among this group, 60 percent echoed concerns about patient suitability, while 55 percent highlighted costs and lack of reimbursement. Remote patient monitoring and client surveys saw smaller adoption increases and similar discontinuation trends.

These patterns suggest that COVID-19 disrupted telehealth’s natural diffusion into home healthcare, which was gaining traction pre-pandemic, with 23 percent adoption by 2019. The study posits that without the pandemic, telehealth might have continued spreading as agencies recognized its benefits. However, the lack of reimbursement and perceptions of telehealth’s limitations for older adults pose barriers to sustained use.

As the Centers for Medicare & Medicaid Services considers telehealth reimbursement policies, the study calls for rigorous evaluations of telehealth’s cost-effectiveness and patient outcomes. With home healthcare expenditures projected to grow significantly, policies supporting telehealth could enhance care delivery and manage costs. The results also underscore the need for future research to assess whether these trends hold across all home healthcare agencies, given the study’s focus on dementia-serving businesses.

The study, co-authored by experts from UC Irvine, UCLA, Brown University, the University of Minnesota and other institutions, is a critical resource for policymakers navigating the future of home healthcare. As the nation grapples with an aging population and rising care demands, understanding telehealth’s role could shape effective, sustainable solutions.

About the University of California, Irvine: Founded in 1965, UC Irvine is a member of the prestigious Association of American Universities and is ranked among the nation’s top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UC Irvine has more than 36,000 students and offers 224 degree programs. It’s located in one of the world’s safest and most economically vibrant communities and is Orange County’s second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. For more on UC Irvine, visit www.uci.edu.

The post Study finds home healthcare agencies discontinuing telehealth post-pandemic appeared first on Pharmacy Update Online.

Inappropriate use of antibiotics is strongly linked to antimicrobial resistance (AMR) in which bacterial illnesses become harder to treat because pathogens are not responsive to existing medicines. Experts have warned that, in an extreme scenario, some bacterial infection would become untreatable. This could tip the risk-benefit balance for routine surgical procedures given the danger associated with hard-to-treat infection.

Healthcare-acquired infections are already a major problem in most care settings, especially hospitals and care homes. In 2020, more than 865,000 resistant infections occurred across the EU and more than 35,000 people lost their lives due to resistant infections every year.

Globally, AMR is estimated to cause 1.2 million direct deaths annually. A further 4.95 million deaths were associated with AMR in 2019. By 2050, forecasts predict 1.91 million deaths directly attributable to AMR and 8.22 million deaths associated with it.

The new study looked at changes in ambulatory use of antibiotics in France between 2020 and 2022. The goal was to assess how disruption to health care access and prescribing patterns would affect antibiotic use.

Researchers used nationwide health insurance data covering 67 million people to track monthly antibiotic prescriptions from January 2010 to March 2022. They applied interrupted time-series analysis to measure changes in antibiotic use following the first national lockdown on March 17, 2020.

The use of most antibiotics significantly decreased after the first lockdown and remained lower for at least 12 months compared with expected levels. Prescriptions of amoxicillin fell by 27.5% after three months, and by 55.5% at 12 months. Use of amoxicillin-clavulanic acid was down 10.9% at 3 months and 24.9% at 12 months. For Cefepime, the figures were down 22% at 3 months and 8.3% at 12 months.

Some antibiotics, such as colistin, phenoxymethylpenicillin and trimethoprim-sulfamethoxazole, which are associated with chronic indications temporarily increased. Azithromycin use did not decrease after the first lockdown and actually increased slightly over 12 months (+2.7%).

The post Antibiotic use plunged during pandemic appeared first on Pharmacy Update Online.

Launched in 2022, PRI is a resource that advances preparedness, builds resilience, and promotes public health throughout the five boroughs of NYC and around the globe.

Key report findings on the role of mutual aid networks in emergency response include:

• Strengthening protections for essential workers
• Rebuilding public trust in health authorities
• Combating misinformation and addressing health inequities
• Economic resilience strategies for small businesses and marginalized communities
• The need for ongoing, sustained public health funding
• Preventing prejudice and discrimination during public health crises

PRI faculty experts available for interviews:

• Sandra Albrecht, PhD, Asst. Prof., Epidemiology, Columbia University; PRI Communications Team Faculty Member – Expert in social epidemiology, socio-cultural and environmental factors influencing diseases in immigrant and Latino populations.
• Jasmine McDonald, PhD, Assoc. Prof., Epidemiology, Columbia University; PRI Racial Equity and Social Determinants of Health Co-Lead – Expert in molecular epidemiology, breast cancer etiology, and health disparities.
• Brian Pavilonis, PhD, Assoc. Prof., Environmental, Occupational, and Geospatial Health Sciences, CUNY SPH; PRI Workforce Capacity and Preparedness Faculty Co-Lead – Expert in occupational health, exposure science, and industrial hygiene.
• Rachael Piltch-Loeb, PhD, Asst. Prof., Environmental, Occupational, and Geospatial Health Sciences, CUNY SPH; PRI Workforce Capacity and Preparedness Co-Lead – Expert in public health emergency preparedness, response evaluation, and risk communication.
• Scott Ratzan, MD, MPA, Distinguished Lecturer, Community Health and Social Sciences, CUNY SPH; PRI Communications Co-Lead – Expert in health communication, health literacy, and strategic diplomacy.
• Jeffrey Shaman, PhD, Prof., Environmental Health Sciences, Columbia University; Interim Dean, Climate School; PRI Epidemiology and Modeling Co-Lead – Expert in infectious disease transmission, environmental determinants, and disease forecasting.

For more information or to arrange interviews, please contact ICAP Communications at icap-communications@cumc.columbia.edu. For more details, visit pri.nyc.

The New York City (NYC) Pandemic Response Institute (PRI) is a resource supporting New York City agencies, organizations, and communities to prepare and respond to critical public health crises

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.

The post COVID-19: Lessons learned at the 5-year mark appeared first on Pharmacy Update Online.

This antibody was isolated from blood samples from an Ebola survivor treated at Emory University Hospital during the 2014-2016 Ebola virus outbreak, an outbreak that began in West Africa and killed more than 11,300 people.

In their new study, the researchers showed that mAb 3A6 helps block infection by binding to an important part of Ebola’s viral structure, called the “stalk.” Study collaborators at the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) found that treatment with mAb 3A6 can benefit non-human primates in advanced stages of Ebola virus disease.

“This antibody offers the best protection in primates, at the lowest dose yet seen for any single antibody,” says LJI Professor, President & CEO Erica Ollmann Saphire, Ph.D., MBA, who led the recent Nature Communications study alongside John A. G. Briggs, Ph.D., of Cambridge University and the Max Planck Institute of Biochemistry; Gabriella Worwa, D.V.M., and Jens H. Kuhn, M.D., Ph.D., of NIAID; and Carl W. Davis, Ph.D., and Rafi Ahmed, Ph.D., of the Emory Vaccine Center.

The discovery that mAb 3A6 appears effective at a very low dose is also exciting. “The lower the amount of an antibody you can deliver to someone, the easier it will be to manufacture a treatment—and the lower the cost,” says study first author Kathryn Hastie, Ph.D., LJI Instructor and Director of LJI’s Center for Antibody Discovery.

How the antibody works

The key to treating Ebola virus is to find antibodies that anchor tightly to and block essential machinery of the virus. The researchers zeroed in on mAb 3A6 because it appears to target a structure on Ebola virus called the “stalk.” The stalk is an important part of the Ebola virus structure because it anchors Ebola’s glycoprotein structure (which drives entry into a host cell) to Ebola’s viral membrane.

The team spearheaded efforts to capture images of mAb 3A6 in action. The researchers used two imaging techniques, called cryoelectron tomography and x-ray crystallography, to show how mAb 3A6 binds to Ebola virus to interrupt the infection process.

The researchers found that mAb 3A6 binds to a site normally concealed by a shifting landscape of viral proteins. “There’s a dynamic movement in these proteins,” says Hastie. “They might kind of wiggle around, move back and forth, maybe lean over a little bit or go up and down.”

Antibody mAb 3A6 takes advantage of this little protein dance. It has such a strong affinity for its viral target that it can slip between the proteins, lift them up, and latch on its target.

Hastie says mAb 3A6’s ability to bind to this target is important for several reasons. First, the site is conserved across different species of Ebola virus, making antibodies that target this region an attractive component in “pan-Ebolavirus” therapeutics. Second, the new understanding of how mAb 3A6 “lifts up” proteins in the viral stalk gives scientists a clearer view of Ebola’s weaknesses. MAb 3A6 also shows us how similar antibodies against the stalks of other viruses might work as well.

“This study gives us some hints for how to design vaccines that are specifically against this region of Ebola virus,” says Hastie.

Additional authors of the study, “Anti-Ebola virus mAb 3A6 protects highly viremic animals from fatal outcome via binding GP(1,2) in a position elevated from the virion membrane,” include Zhe “Jen” Li Salie, who solved the X-ray structure; Zunlong Ke, who performed the cryoelectron tomography; Lisa Evans DeWald, Sara McArdle, Ariadna Grinyó, Edgar Davidson, Sharon L. Schendel, Chitra Hariharan, Michael J. Norris, Xiaoying Yu, Chakravarthy Chennareddy, Xiaoli Xiong, Megan Heinrich, Michael R. Holbrook, Benjamin Doranz, Ian Crozier, Yoshihiro Kawaoka, Luis M. Branco, Jens H. Kuhn

This study was supported in part by the National Institute of Health’s National Institute for Allergy and Infectious Diseases (grant U19 AI142790, Contract No. HHSN272201400058C, Contract No. HHSN272200700016I, Contract No. HHSN272201800013C), DARPA (contract W31P4Q-14-1-0010), and UK Medical Research Council (grant MC_UP_1201/16), the European Research Council (ERC-CoG-648432 MEMBRANEFUSION), and the Max Planck Society.

DOI: 10.1038/s41467-025-56452-2

The post New Ebola virus research boosts pandemic preparedness appeared first on Pharmacy Update Online.

Nearly three million COVID-related prescriptions were issued in the three and a half years between January 30, 2020 and June 30, 2023, totaling $272 million in estimated spending. Usage was three times higher among adults aged 65 and older compared with those aged 18 to 64. Ivermectin use in particular was higher among people living in the most socially vulnerable neighborhoods and markedly higher in the Southern United States.

These findings, published in the peer-reviewed journal Health Affairs, may inform future policies aimed at reducing the harms caused by reliance on non-evidence-based treatments, especially among vulnerable communities.

“Our findings underscore the urgent need for policy reforms to combat misinformation and mistrust in scientific institutions. Eliminating undue industry influence in government, enhancing transparency around scientific uncertainty, and earmarking public funding for clinical trials of new drugs are good places to start,” said Dr. John Mafi, associate professor-in-residence in the UCLA Division of General Internal Medicine and Health Services Research and the study’s senior author.

The researchers used insurance claims listed in the Milliman MedInsight Emerging Experience Research Database for 8.1 million patients from across all 50 states to assess utilization and spending for the two medications from January 30, 2020 to June 30, 2023.

Among the findings were:

• Nearly three million COVID-related prescriptions in outpatient settings during the study period, totaling $272 million.
• Hydroxychloroquine use peaked in March 2020 to 133% of pre-pandemic rates
• Ivermectin use surged in 2020 and throughout 2021, and by August 2021 peaked at more than 10 times higher than pre-pandemic rates
• After FDA-authorized COVID-19 medications (e.g., Paxlovid) became available, ivermectin and hydroxychloroquine use dropped by 93% in outpatient settings from March 1, 2022 to June 30, 2023.
• Of the estimated $272 million spent for COVID-19-related hydroxychloroquine and ivermectin, approximately $18 million was spent after March 2022 when FDA-authorized COVID medications became available.
• Limited availability of COVID-19 medications does not appear to explain the wide geographic variation in ivermectin prescribing, particularly in the South.

There are some limitations to the study. The cohort included what is called a “convenience sample,” meaning that the researchers used data from a group that was easy, or convenient, to sample rather than randomly chosen. While the findings may thus not be generalizable, prior work confirms that the demographics in the dataset the researchers used reflect the U.S. population as a whole. In addition, medications that patients obtained without insurance or a prescription were not included in the analysis; variations in the price of ivermectin and hydroxychloroquine around the country may not have been captured in the researcher’s spending estimates for the drugs. Additionally, the researchers attributed the increase in the drugs’ usage rate to their utilization for COVID treatment although not all the claims in the data noted that.

“To our knowledge, this is the first study to report on trends in ivermectin and hydroxychloroquine utilization and spending in U.S. outpatient settings throughout the entire COVID-19 pandemic. This utilization represents wasteful spending and potentially avoidable harm. Our findings highlight the complex drivers of non-evidence based care, particularly in a time of uncertainty and distress. Multilevel efforts to enhance equitable, high-value care while minimizing non-evidence-based care are needed,” said Dr. Michelle Rockwell, the study’s lead author and assistant professor of family & community medicine at Virginia Tech Carilion School of Medicine.

Study co-authors included Sitaram Vangala and Dr. Katherine Kahn of UCLA; Jonathan Cantor and Cheryl Damberg of RAND Corporation; Michael Hadfield,  Dale Skinner and Melody Craff of Milliman MedInsight, and Dr. A. Mark Fendrick of the University of Michigan.

This study was funded by the Commonwealth Fund, the National Center for Advancing Translational Sciences, National Institutes of Health (KL2TR003016 and UL1TR003015), and the National Institute on Aging/National Institutes of Health (K76AG064392).

The post Ivermectin, hydroxychloroquine prescriptions during the COVID-19 pandemic soared far above pre-pandemic levels appeared first on Pharmacy Update Online.

In the early part of the pandemic, retail alcohol sales volume in Canada increased by 2% (2020/21 v. 2019), the highest increase in 10 years, despite few international visitors. More than 1 in 4 people (26%) reported drinking more, and 18% reported heavy drinking (defined as ≥ 5 drinks for men, ≥ 4 for women in a single sitting).

To understand the effect of changing patterns of alcohol use during the pandemic, researchers looked at deaths and hospitalizations between 2016 and 2022, comparing a prepandemic period and a pandemic period. They found that deaths from alcohol use increased about 18% over the 3-year period, with higher increases mainly in 2020 and 2021 (about 24%), resulting in 1600 more deaths than expected. Alcohol-related hospitalizations also increased 8% over the pandemic period studied, with higher increases (about 14%) in 2020/21.

“The 1596 excess deaths and 7142 excess hospitalizations fully attributable to alcohol we observed in Canada during the pandemic period that we studied speak to the substantial harms of increased alcohol consumption that can occur given circumstances and availability, and speak to the need for robust interventions,” writes Dr. Yipu Shi, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, with coauthors.

There were regional variations, with the highest increases in deaths in the Prairie provinces (28%) and in British Columbia (24%), excess rates 3 times higher than in Ontario and the Atlantic provinces, and 6–7 times higher than in Quebec. Hospitalizations were also higher in the Prairies and especially in the territories. Younger adults had the highest increases in both excess deaths (age 25–44 yr) and hospitalizations (age 15–44 yr).

Deaths and hospitalizations were largely due to alcoholic liver disease (ALD) and alcohol use disorder (AUD). As increases in hospitalizations were 3 times higher in females, the authors suggest this could be an early warning of future liver-related disease in this group.

These findings echo those from other countries, including the United States, which had a 29% increase in alcohol-related deaths (2020/21), and Europe (18%).

Increased alcohol consumption may have been driven by stress, boredom, deteriorating mental health, and other factors, including easier access to alcohol.

“Our findings highlight the importance of timely interventions to prevent high-risk drinking from developing into AUD or ALD. A comprehensive approach to preventing and managing high-risk drinking, AUD, and ALD in the aftermath of the pandemic should comprise both public health and clinical management interventions,” the authors conclude.

The post Alcohol-related deaths up 18% during pandemic appeared first on Pharmacy Update Online.

Using a sample of more than 2,000 older adults with migraine from the Canadian Longitudinal Study on Aging, researchers examined changes in depression status among this population during the pandemic. More than 1 in 7 older adults with migraine experienced depression for the first time during the COVID-19 pandemic, while approximately 1 in 2 with a previous history of depression experienced a recurrence during this period.

“People living with migraine are already known to be highly vulnerable to adverse mental health outcomes, such as depression,” said senior author Esme Fuller-Thomson, a professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work (FIFSW) and director of the Institute for Life Course & Aging (ILCA). “Considering the increases in stressors during the pandemic, such as disruptions to medication and healthcare access, we wanted to understand how this may have impacted the mental health of those with migraine.”

The researchers looked at risk factors for depression to better understand the subpopulations of people with migraine that had the highest risk of pandemic-related depression.

Increased family conflict during the pandemic was associated with a five-fold risk of incident depression and a three-fold risk of recurrent depression.

“Many families experienced increased discord and conflict during periods of lockdown, which were coupled by declines in access to important coping mechanisms that can mitigate family stress, such as physical activity outside and time spent socializing with friends. This likely impacted the mental health challenges observed during the pandemic,” said co-author Andie MacNeil, PhD student at FIFSW.

Other pandemic-related stressors that were associated with incident depression among older adults with migraine included experiencing difficulty accessing healthcare.

“Access to comprehensive healthcare was already recognized as a major challenge for people with migraine prior to the pandemic,” said co-author Aneisha Taunque, a research assistant at the Institute for Life Course and Aging. “We know access to healthcare worsened during the pandemic, which may have exacerbated mental health challenges among this population.”

Increased time spent caregiving and/or challenges linked to caregiving were also associated with incident depression, which, like difficulties in accessing health care, approximately doubled the risk of incident depression.

“Caregiving responsibilities can be extremely challenging for people living with debilitating pain, such as that caused by migraine — and many people reported increases in their caregiving responsibilities during the pandemic,” said co-author Ying Jiang, Senior Epidemiologist at the Public Health Agency of Canada.

Other contributors to the study include Sarah Leo, a recent MSW graduate from FIFSW, Dr. Grace Li, who was a research associate with ILCA, and Margaret de Groh, a retired Scientific Manager at the Public Health Agency of Canada.

The authors emphasized the importance of ongoing research to examine depression among people with migraine.

“It will be important to identify if the observed increases were a temporary occurrence due to pandemic-related stressors, or if these trends have persisted after the pandemic,” said Fuller-Thomson. “This knowledge can help inform targeted screening and intervention for people with migraine.”

The post People with migraine at high risk of depression during pandemic appeared first on Pharmacy Update Online.

“More U.S. college students suffered from mental health concerns during the pandemic, but fewer received necessary mental health treatment,” says Russell.

This study is the first to use a national dataset to examine changes in university students’ psychological well-being and their utilization of mental health services from pre-COVID-19 to peak pandemic. Russell and the research team found that, consistent with prior research related to diverse populations, racial/ethnic, gender, and sexual minority groups were at a greater risk of suffering from poor mental health during the pandemic. Additional findings revealed that during the pandemic, students of color, especially female students of color, were less likely to receive mental health services.

“When developing innovative approaches to improving mental health outcomes on college campuses, it is important to be culturally sensitive and understand the diverse needs of the specific student population,” says Russell.

The study used data from before the COVID-19 pandemic (Fall 2019 and early Spring 2020) and during the pandemic (Spring 2021) to examine mental health symptoms and utilization of mental health services among university students. The sample was limited to full-time undergraduate students aged 18-24 attending four-year universities in the United States. In addition to analyzing the entire sample of university students, the team examined demographic subgroups based on race/ethnicity, sexual orientation, and gender identity.

Several validated psychological testing scales were used in the study to indicate students’ self-reported levels of psychological distress, loneliness, overall stress, psychological well-being, and resilience. Additional survey questions asked about COVID-19 specific stressors, including the students’ concern over themselves or their loved ones getting COVID-19 and being unable to spend time with the people they care about due to the pandemic lockdowns. Students’ use of mental health services within the 12 months preceding the survey was also assessed.

“These findings are important to better understand sub-groups who disproportionally suffer from severe psychological distress but may not be accessing the necessary care,” the study reports. While issues such as a lack of access to mental health services and discrimination within the healthcare system are undoubtedly factors in students’ reluctance to seek mental health care, the stigma surrounding mental health is also prohibitive.

“Improvements in mental health resources must also address stigma and empower students to access necessary care,” Russell says, specifying the use of peer health educators and making efforts to normalize mental health treatment may be effective prevention strategies.

Russell concludes by calling for future research to increase understanding of the barriers to mental health service use among high-risk university students.

“Impact of the COVID-19 pandemic on university students’ psychological distress, well-being, and utilization of mental health services in the United States: Populations at greatest risk” will be published online in Frontiers in Public Health October 30, 2024.

The authors are: Elaine Cooper Russell, George Mason University; Tolulope M. Abidogun, George Mason University; Lisa L. Lindley, Lehigh University; Kenneth W. Griffin, George Mason University.

About College of Public Health at George Mason University

The College of Public Health at George Mason University is the first College of Public Health in Virginia and a national leader in inclusive, interprofessional, public health research, education, and practice. The College is comprised of public health disciplines, health administration and policy, informatics, nursing, nutrition, and social work. The College offers a distinct array of degrees to support research and training of professionals dedicated to ensuring health and well-being for all. The College’s transdisciplinary research seeks to understand the many factors that influence the public’s health and well-being throughout the lifespan. Areas of focus include prevention and treatment of infectious and chronic diseases, inequalities and marginalized communities, environmental health and climate change, nutrition, violence, mental and behavioral health, informatics, and health technologies. With more than 500 partners, the College serves the community through research, practice, and clinical care with a focus on the social determinants of health and health equity.

The College enrolls more than 1,900 undergraduate and 1,300 graduate students in our nationally-recognized programs, including 5 undergraduate degrees, 7 master’s degrees, and 4 doctoral degrees, and 10 certificate programs. Our graduates are uniquely prepared to thrive in an increasingly multicultural, multidisciplinary, community-focused public health landscape.

The post New study shows that university students experienced increased psychological distress during COVID-19, but utilized fewer support services appeared first on Pharmacy Update Online.

The new study found that the pandemic didn’t lead to increases in postpartum depression or anxiety diagnoses. But it did prompt a 15% increase in the number of privately insured new moms filling prescriptions for antianxiety medications like Valium, Xanax, Ativan and Klonopin.

The researchers didn’t find an increase in SSRI prescriptions, though.

SSRIs, or selective serotonin reuptake inhibitors, are the gold standard for treating both depression and anxiety disorders. But these drugs, which include medications like Zoloft, Prozac and Lexapro, take time to work.

Benzodiazepines, also known as benzos, are sometimes used as a stopgap during the month or two it takes for an SSRI to start working. But they aren’t a substitute for SSRIs. And they carry significant risks of dependence and abuse.

“What concerns me the most is not what we found but what we didn’t find,” said Grace Bagwell Adams, lead author of the study and an associate professor in UGA’s College of Public Health. “You can’t tell me there wasn’t more depression and anxiety in this population during the pandemic. And historically, even pre-COVID, postpartum depression and anxiety has always been underdiagnosed. But we didn’t find an increase in diagnoses.”

Postpartum depression, anxiety largely underdiagnosed. The pandemic didn’t help.

One in 10 women experience postpartum depression or anxiety in the first six months after giving birth. The majority aren’t properly diagnosed and don’t receive treatment for the conditions.

The researchers analyzed data from more than 518,000 privately insured postpartum women from January 2016 through December 2020. Despite reported increases in anxiety and depression across the board after the onset of the pandemic, the researchers found no evidence of an increase in diagnoses of postpartum depression or postpartum anxiety.

This suggests that the underdiagnosis and undertreatment of these conditions was exacerbated by the pandemic-induced health care crisis, the researchers said.

Many insurers only cover one postpartum visit, typically at about six weeks after giving birth. Health care providers are supposed to screen for depression and anxiety at these visits.

But during COVID, it’s likely that many women didn’t have that appointment, Bagwell Adams said. Or if they did, it may have taken place via telehealth, which isn’t always ideal for discussing difficult mental health challenges.

“One of the top causes of maternal mortality is suicide,” Bagwell Adams said. “When these women don’t get diagnosed and they don’t receive proper treatment, they die. And it’s not that postpartum women didn’t see their doctor in time. It’s that they aren’t being listened to.”

Benzos aren’t a substitute for SSRIs when it comes to depression

After the birth of her son during the pandemic, Bagwell Adams experienced that lack of communication firsthand at her postpartum checkup.

“We had a chat, and I told him I was basically crippled by anxiety and depression,” she said. “He was like, ‘Let’s get you something to help calm you down.’ I thought he was going to send me home with an SSRI.”

Instead, her doctor prescribed a benzo.

As someone who’s dealt with anxiety for years, Bagwell Adams knew that wasn’t going to cut it. After some back and forth with her doctor, she was prescribed Lexapro. But many patients wouldn’t know to push back like she did.

“The thing I get really worried about it is that this is what we found for the cream of the crop in terms of insurance coverage,” Bagwell Adams said. “The women in this sample have private insurance. This is the best-case scenario for the United States, and that doesn’t look good.”

Combining opioids with benzos likely increased. That combination can be deadly.

Another concerning side effect of increased benzo prescriptions is interactions with other medications, particularly opioids.

More than seven out of every 10 women who give birth via C-section and one in four who deliver vaginally are prescribed opioids for pain management. And previous research shows that opioid prescriptions for postpartum women increased during the COVID-19 pandemic.

But combining opioids with benzos can be deadly. And the likelihood that some of the women who filled benzodiazepine prescriptions were simultaneously taking pain medications is high, the researchers said.

“For me, this study highlights more questions than answers,” Bagwell Adams said. “There’s something bigger happening here that is really disconcerting when it comes to treating women in general and postpartum women in particular.”

Published in Archives of Women’s Health, the study was funded in part by a grant from the National Institute on Drug Abuse. Co-authors include Emily Lawler and Amanda Abraham, from UGA’s School of Public and International Affairs; Shelby Steuart, a doctoral graduate of UGA’s School of Public and International Affairs who is now a postdoctoral researcher at the University of Chicago, and Hailemichael Shone, of Indiana University.

The post Postpartum women filled more benzodiazepine prescriptions during pandemic appeared first on Pharmacy Update Online.