Evidence map›Paper›PMID 42268840›Full record

ArticlePloS one2026

Prescription patterns of inhaler medications from 2017 to 2023: A retrospective study using Ontario administrative healthcare data.

Anthony Train, Krishna K Vemuri, Angela Coderre-Ball, Javier Silva-Valencia, Declan Mulligan, Debra A Butt, Jessica Gronsbell, Braden O'Neill, Andrea Gershon, Karen Tu

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anthony TrainResearch and Innovation, North York General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0009-0006-5025-6110
Krishna K VemuriResearch and Innovation, North York General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-1277-6757
Angela Coderre-BallResearch and Innovation, North York General Hospital, Toronto, ON, Canada.
Javier Silva-ValenciaResearch and Innovation, North York General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-5982-2821
Declan MulliganDepartment of Family Medicine, Queen's University, Kingston, ON, Canada.
Debra A ButtResearch and Innovation, North York General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-0170-0522
Jessica GronsbellResearch and Innovation, North York General Hospital, Toronto, ON, Canada.
Braden O'NeillResearch and Innovation, North York General Hospital, Toronto, ON, Canada.
Andrea GershonResearch and Innovation, North York General Hospital, Toronto, ON, Canada.
Karen TuResearch and Innovation, North York General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-0883-4934

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInhalers are essential for respiratory disease management, but commonly used metered-dose inhalers (MDIs) can often be replaced, when clinically appropriate, with lower-emission alternatives such as dry powder inhalers (DPIs) or soft mist inhalers (SMIs). The COVID-19 pandemic may have influenced prescribing patterns. We aim to describe changes in inhaler prescription trends and determine whether MDI use decreased during the pandemic. METHODS AND

findingsRetrospective cohort study using Ontario's health administrative data. Individuals aged 65 and older with new inhaler prescription instances from April 1, 2017, to March 31, 2023, were included. Monthly prescription event rates by inhaler type and socioeconomic factors were modeled for pre-pandemic (April 2017-March 2020) and pandemic (April 2020-March 2023) periods using interrupted time series and Generalized Additive Models to account for autocorrelation and seasonality. 750,517 new inhaler prescriptions were made during the study period. A significant drop was observed at the pandemic's onset. MDIs were the predominant type of inhaler initially prescribed for both pre-pandemic ~77% and pandemic ~70% periods. The proportion of DPI initial prescriptions modestly increased from ~17% to ~23% and SMI initial prescriptions remained similar. Inhaler prescription rates did not significantly differ across sex, income quintiles, or rurality.

conclusionsThe COVID-19 pandemic disrupted inhaler prescribing patterns in Ontario, leading to a temporary decline in new prescriptions. Despite environmental and guideline recommendations, MDIs continued to dominate prescribing practices. These findings underscore the need for targeted interventions to align clinical practices with current guidelines and environmental sustainability goals.

Indexed as

COVID-19Drug PrescriptionsMetered Dose InhalersPractice Patterns, Physicians'Administration, InhalationAgedDry Powder InhalersFemaleHumansMaleNebulizers and VaporizersOntarioRetrospective StudiesSARS-CoV-2

Identifiers

PMID42268840
PMCPMC13252740

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.