Project #189:
Impact of Covid-19 pandemic on prevalence, patterns and variations of COPD ‘rescue packs’ prescribing in primary care in England

Chronic obstructive pulmonary disease (COPD) is a long-standing condition of the lungs which worsens over time. It causes shortness of breath and often leads to flare ups.

Patients can be prescribed medications to keep at home in case of another flare up. These are called rescue packs and usually contain an antibiotic and a steroid to be taken by mouth. These medications don’t always benefit patients and may even cause harmful side effects. Therefore, it is important that rescue packs are used only when they are truly needed. Some patients report being unsure how to make the decision when to take or not take their rescue packs, especially as they are unwell with the flare up at the time.

When rescue packs are on repeat prescriptions, doctors might miss recording patients’ flare ups. This often means that they miss chances to review and adjust the treatment to prevent future flare ups or refer patients to a specialist.

Patients told us that the Covid-19 pandemic, which limited their access to primary care, led to more rescue packs being started. We need to check the prescribing data to assess if rescue packs prescriptions increased during the pandemic and if yes, if they have returned to the pre-pandemic levels. This will allow us assess the effect of the pandemic on remote COPD care.

To deliver this work, we will look at GP medical records across England using a secure system called OpenSAFELY to understand how many rescue packs are given out. We will also check what factors influence these differences (e.g., patients’ age, sex, other diseases, or practice size and location). We will study all adults with COPD between January 2014 and December 2024, which will help us understand the trends in rescue packs prescribing before, during and since the pandemic.

This research is important because using rescue packs incorrectly can lead to problems with antibiotic resistance and side effects, and can mean that patients don’t received the best care.

Our findings will help GPs and healthcare planners improve COPD care. This work will also help us with the next stage of the project where we will speak with patients and prescribers to understand their experience of rescue packs during and after the pandemic.