JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has profoundly affected the mental health care system globally, and patients with mental disorders were more vulnerable to various challenges caused by pandemic-related quarantine measures. To ensure continuous and accessible pharmaceutical services for those patients, the Affiliated Brain Hospital, Guangzhou Medical University has implemented an internet-based hospital platform to offer remote pharmaceutical services.

Objective:

This study aimed to analyze the characteristics and trends of internet-based psychiatric hospital prescriptions during and after the COVID-19 pandemic.

Methods:

The electronic prescriptions from November 10th 2020 to December 31st 2023 were collected from the internet-based hospital. The characteristic analysis included factors such as gender, age, primary diagnosis, medications, audit time, approval rate, and the number of prescriptions per month.

Results:

In this study, a total of 17,330 electronic prescriptions were collected from the internet-based hospital. During the pandemic phase, there were 11,812 prescriptions, with a male-to-female ratio of 1:1.62 and 47.46% of patients aged 18-40. Comparatively, in the post-pandemic phase, among 5,518 prescriptions, the gender ratio shifted to 1:1.76, the proportion of patients aged 18-40 increased marginally to 48.15%. Regarding primary diagnosis, during the pandemic phase, the top three diagnoses were depressive disorder (n=3,539, 29.96%), schizophrenia (n=2,095, 17.74%), and bipolar disorder (n=1,632, 13.82%). In the post-pandemic period, the top three diagnosis changed to depressive disorder (n=2,094, 37.95%), mood disorder (n=1,191, 21.58%), and schizophrenia (n=607, 11.00%). Quetiapine, lithium carbonate, and escitalopram remained the most prescribed medications throughout both periods. Prescription processing times showed notable variations. During the pandemic, 50.79% of prescriptions were audited within 5 minutes, compared to 18.09% post-pandemic. Conversely, prescriptions audited within 1-12 hours increased from 12.41% to 36.81% between periods. Rates of pharmacist approval and Physician double-check requirements demonstrated significant improvements. The proportion of prescriptions approved by pharmacists increased from 83.34% to 96.54%, while the proportion of prescriptions double-check by doctors decreased from 16.47% to 3.41%. Internet-based hospital utilization revealed dramatic growth. Initial operations yielded only 76 prescriptions (0.44%) in the first seven months, which surged to 3,427 (19.77%) during the month of suspended outpatient services. After the pandemic prescription volumes stabilized at approximately 460 per month.

Conclusions:

The psychiatric hospital demonstrated the online medication services provided by internet-based hospitals were increasingly embraced by patients and evolved into routine healthcare solutions. This study revealed the characteristics and trends of electronic prescriptions in internet-based psychiatric hospitals during and after the COVID-19 pandemic, and may provide reference for public crisis in the future.