COVID-19 and lockdown: The highs and lows of general practitioner prescribing

As a result of the global COVID-19 pandemic and subsequent national lockdown, general practices tried to limit unnecessary footfall into surgeries during this period. This paper aims to investigate how General Practice (GP) prescribing changed following the first COVID-19 lockdown by analysing open-source General Practice prescribing data in England and Northern Ireland. Prescribing data was obtained for the calendar years 2019 and 2020 at British National Formulary (BNF) chapter and section levels, aggregated and compared year on year and with each other. Particular attention was given to the change in prescribing between February and March of both years to examine the change in prescribing immediately following the start of the lockdown.Prescribing markedly increased across BNF categories in March 2020 followed by a dip and return to pre-COVID-19 levels in late summer. The rise in the number of items prescribed in England between February and March 2020 was nearly twice that seen in the same period the previous year (14.5% vs 7.6%). Northern Ireland saw a much greater relative increase of 20.7.The "peak, trough and recovery" pattern observed across BNF chapters reflected patients obtaining bigger stocks of prescriptions pre-lockdown. The higher Northern Ireland peak may be part-explained by lack of electronic transfer to pharmacies which exists in England. Increased antimicrobial prescribing, which spiked in March 2020, may relate to issuing "rescue packs" at the outset of the pandemic, with the sustained decline in the following months a possible effect of Covid measures and reduced consulting.