An examination of 3.8 million patient records from general practices across NSW and Victoria in 2022-23 has shown just over three per cent of patients were prescribed oral COVID-19 antivirals, but that number was higher for older age groups.
The study, by researchers from the Australian Institute of Health Innovation at Macquarie University, analysed routinely collected deidentified consultation and prescription information from 938 general practices between March 2022 and September 2023.
Two oral COVID-19 antivirals were approved for use in Australia in January 2022, and were added to the Pharmaceutical Benefits Scheme in March and May 2022 respectively.
Initially, eligibility was restricted to patients with specified risk factors, including age, living in residential aged care, or having certain health conditions. These were expanded during 2022-23.
The study’s senior author, Professor Andrew Georgiou says the research was undertaken to look at gaps in the knowledge around how oral COVID-19 antivirals were being prescribed in general practice, including patient demographics and the role played by telehealth.
“Greater understanding of the uptake of oral COVID-19 antivirals can help inform future directions for eligibility criteria, provide a better comprehension of the characteristics of patients receiving treatment, and identify demands on general practice,” he says.
“Out of our sample, 3.39 per cent of patients aged 15 years and older were prescribed antivirals, but that rose to 14.79 per cent of those aged 70 and older, with the 80 to 84 age group being the most likely to receive prescriptions.
“They were more likely to be prescribed to females than males, to people in Victoria than those in NSW, and to those in higher socioeconomic groupings.”
Our results suggest that ... we can use the volume of oral COVID-19 antivirals being prescribed by GPs as another indicator of periods of increased transmission.
The majority of patients who were prescribed antivirals only received one prescription in the 19-month study period, with just over seven per cent receiving more than one prescription.
Patients with chronic conditions – particularly cardiovascular and musculoskeletal conditions – were also more likely to receive antivirals, which provides important insights into health characteristics of patients seeking the treatment.
Tracking waves and the importance of telehealth
Professor Georgiou says monthly prescribing volumes also aligned with COVID-19 waves.
“At the height of the pandemic, it was mandatory to report a positive COVID-19 test result, and this fed into state and federal health department data, which was vital for disease tracking,” he says.
“That data is no longer collected, but COVID continues to circulate in the community.
“Our results suggest that in its absence, we can use the volume of oral COVID-19 antivirals being prescribed by GPs as another indicator of periods of increased transmission.”
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Another key finding was that telehealth was used for more than 54 per cent of consultations where COVID-19 antivirals were prescribed.
Professor Georgiou says this shows continued access to telehealth is required for COVID-positive patients, as it allows primary healthcare teams to provide time-critical care while reducing their exposure to the SARS-CoV-2 virus.
This study was supported by Digital Health CRC, which is funded under the Commonwealth’s Cooperative Research Centres (CRC) Program.
Professor Andrew Georgiou is a health informatics researcher at the Australian Institute of Health Innovation at Macquarie University.
