CCU014: Assessing the impact of COVID-19 on clinical pathways using a medicines approach

Project lead:
Reecha Sofat, University of Liverpool

Cardiovascular disease (CVD, including heart attacks and strokes) remains one of the leading causes of death in the UK. There are a number of conditions that commonly increase an individual’s risk of developing CVD. Some of these conditions, such as diabetes and having high circulating levels of cholesterol in the blood, can be controlled by using medicines.

However, these conditions need to be diagnosed before an individual can be prescribed the medicines to control them. Because of disruption from the COVID-19 pandemic resulting in changes in health care services and fewer face-to-face medical appointments, it is likely that the number of conditions being diagnosed has fallen. Therefore some individuals are not being prescribed the medicines to control the condition.

One way to investigate this problem is to look at what changes there have been in the prescriptions for these conditions. This involves looking at new and repeat prescriptions that have been issued by the GP, and also the amount of prescriptions dispensed by the pharmacy.

We already know that the COVID-19 pandemic caused a disruption to the usual pattern of prescribing of medicines for these conditions. For example, there was a significant increase in the number of repeat prescriptions issued in March 2020, presumably as doctors and patients ensured they had sufficient medication for the first lockdown. Subsequent patterns in the prescribing of medicines for these conditions during 2020 have not yet been adequately studied.

The number of GP appointments also fell during Spring-Summer 2020, presumably resulting in a reduced number of individuals being diagnosed with CVD. It is also presumed that there would be a reduction in the diagnosis in new patients of conditions that can increase their risk of developing CVD, and therefore a decrease in the amount of prescriptions for medicines to control these conditions.

For this project, we therefore propose to examine patterns in the prescription of medicines for these conditions. This will enable us to understand how the COVID-19 pandemic has had an impact on the control of CVD and its related conditions in the UK population. We will use this information to understand how many people are likely to be affected by cardiovascular disease in the future. It is hoped that this will enable more accurate planning for better patient care.


The scope of this project has been extended to understand the impact of COVID-19 on a number of clinical pathways using medicines as an approach.  This additional work is funded through a funding call by Health Data Research UK and the Alan Turing Institute as part of the wider Data and Connectivity National Core Study.

Further details are available here.


The impact of the COVID-19 pandemic on cardiovascular disease prevention and management

  • Nature Medicine publication 19/01/23 can be viewed here
  • medRxiv preprint 02/01/22 can be viewed here
  • Code and phenotypes used to produce this paper are available in GitHub here

Use of sodium valproate and other anti-seizure medications in England and Wales during the COVID-19 pandemic: a population-level analysis of 60 million individuals

  • Paper submitted to a journal (decision pending)
  • Preprints with The Lancet preprint 23/08/23 can be viewed here
  • Code and phenotypes used to produce this paper are available in GitHub here