Comparative Analysis of Prescriptions and Pharmacy Services in Internet-Based Psychiatric Hospital During and After the COVID-19 Pandemic: Retrospective Cross-Sectional Observational Study (Preprint)

Background: The COVID-19 pandemic has profoundly affected mental health management globally, accelerating the development of internet-based hospitals and telepharmacy services. However, their characteristics and evolving trends remain unclear. Objective: This study analyzed the features and trends of prescriptions and pharmacy services in an internet-based psychiatric hospital, aiming to provide references for the development of digital health service models. Methods: We conducted a retrospective observational study using the 17330 electronic prescriptions processed in the internet-based psychiatric hospital of the Affiliated Brain Hospital of Guangzhou Medical University during November 2020 to December 2023. The time point of December 2022 was applied to divide the pandemic and post-pandemic phases. The trends of monthly prescriptions were evaluated using interrupted time series (ITS) analysis. The demographic/clinical factors, including patients’ gender and age, diagnosed disease, drug type, and pharmacist audit time and outcome, were analyzed using bootstrap method, Pearson’s chi-square analysis, and multinomial logistic regression. Results: The ITS segmented regression model indicated a significant increasing tendency of prescriptions in pandemic phase (R2 = 0.30, p = 0.018) and a generally flat trend in post-pandemic phase (R2 = 0.22, p = 0.127). Descriptive analysis with bootstrap validation revealed that females accounted for the majority [pandemic: 61.78%, 95% CI (60.91-62.70); post-pandemic: 63.79%, 95% CI (62.58-65.18)]. Young adults aged between 18-40 years were the predominant population [pandemic: 47.46%, 95% CI (46.63-48.39); post-pandemic: 48.15%, 95% CI (46.79-49.37)]. Depressive disorder was the leading diagnosed disease [pandemic: 29.96%, 95% CI (29.15-30.79); post-pandemic: 37.95%, 95% CI (36.74-39.12)], whereas quetiapine was the most commonly prescribed drug [pandemic: 10.44%, 95% CI (10.03-10.81); post-pandemic: 11.94%, 95% CI (11.37-12.55)]. The majority of prescriptions were audited within 5 minutes during pandemic [50.79%, 95% CI (49.89-51.65], while most prescriptions were audited within 1-12 hours in post-pandemic phase [36.81%, 95% CI (35.61-37.95]. Pearson’s chi-square analysis and multinomial logistic regression indicated that factors positively correlated with pandemic phases included female [p = 0.011, OR = 1.09, 95 % CI (1.02-1.17)], aged ≤ 17 years [p < 0.001, OR = 2.20, 95 % CI (1.90-2.54)], aged 18-40 years [p < 0.001, OR = 1.59, 95 % CI (1.38-1.83)], audit time 12-24 hours [p = 0.018, OR = 6.26, 95 % CI (1.38-28.49)], and approved outcome [p = 0.025, OR = 3.97, 95 % CI (1.19-13.26)]. The audit time ≤ 5 minutes [p = 0.049, OR = 0.22, 95 % CI (0.05-0.99)] was negatively associated with pandemic phases. Conclusions: Our results demonstrated that internet-based psychiatric hospital was efficient in providing continuous pharmacy services in both pandemic phases. These findings filled the research gap in this domain, offering valuable references for the improvement of healthcare service models. The substantial sample size, long-term timespan, and statistical analysis enhanced the reliability and robustness of our findings.