A landmark study published in Nature Health has unveiled unprecedented insights into medication use across England, charting detailed patterns from national primary care dispensing data. This comprehensive analysis, conducted by researchers at the British Heart Foundation (BHF) Data Science Centre at Health Data Research UK in partnership with the University of Liverpool, leverages linked electronic health records (EHR) to explore how medicines are prescribed and dispensed across different demographics during the entire COVID-19 pandemic and the recovery period.
Drawing upon an immense dataset encompassing 52.6 million individuals and 5.8 billion medication records between November 2019 and December 2024, the researchers achieved unparalleled granularity in understanding medication dispensing trends. Data spanning factors such as age, sex, ethnicity, deprivation levels, and geographic location revealed complex, often stark inequalities in medicine use that demand urgent attention from policymakers and healthcare providers alike.
One of the most striking discoveries is the sharp deprivation gradient in medication dispensing. By age forty, individuals in the most deprived communities were dispensed nearly twice as many different medicines compared to their counterparts in the least deprived groups. Furthermore, these medicines were prescribed earlier in life, suggesting a greater burden of disease and possibly less effective preventive healthcare among socioeconomically disadvantaged groups. This insight underscores deep-rooted health inequities that fuel differences in morbidity and mortality.
Sex and ethnicity were also powerful determinants of medication use patterns. Women began receiving more medications earlier than men, with a pronounced prevalence for drugs related to mental health conditions. The analysis highlighted particularly elevated dispensing rates among Bangladeshi and Pakistani ethnic communities, emphasizing the importance of culturally and demographically targeted healthcare interventions to optimize therapeutic outcomes and avoid potential overtreatment or undertreatment.
Polypharmacy — the concurrent use of multiple medications — emerged as a growing phenomenon, particularly among older adults but also notable in younger populations. Over 40% of people aged 70 and above were dispensed five or more distinct medications, heralding challenges including increased risks of drug-drug interactions, adverse effects, and the complexity of managing multiple chronic conditions. Surprisingly, even among toddlers, 5% of three-year-olds received three or more medicines, stimulating questions about pediatric prescribing practices and their long-term impacts.
The COVID-19 pandemic instigated notable disruptions followed by shifting trends in medication dispensing. A precipitous drop in new prescriptions was documented in 2020, particularly for chronic conditions like cardiovascular disease and diabetes. However, dispensing rates for these conditions rebounded swiftly and surpassed prepandemic baselines during the subsequent recovery, reflecting a catch-up in diagnosis and treatment. Contrastingly, medications for mental health disorders declined during the pandemic and failed to return to prior levels, highlighting potential service gaps and unmet clinical needs exacerbated by ongoing public health challenges.
This research exploited a unique legal and ethical framework, enabled by the Control of Patient Information (COPI) notices issued during the pandemic, which allowed secure, approved access to linked GP and prescribing records. By removing identifiable information and using stringent security protocols within NHS England’s secure data environment, the study maintained rigorous patient confidentiality while illuminating rich, population-wide medication data. However, these emergency data-sharing permissions have lapsed, highlighting an urgent call for permanent pathways to facilitate ongoing, real-time pharmaceutical surveillance essential for public health.
Professor Reecha Sofat, Associate Director of the BHF Data Science Centre at Health Data Research UK, emphasized the transformative potential of this population-scale data linkage approach for healthcare. She stated, “For the first time, we can observe how medications are used across an entire nation, pinpointing exactly where disparities exist. This lays the foundation for more effective, equitable, and safer prescribing practices — ensuring that the billions invested annually in medicines deliver real value for patients and taxpayers.”
Complementing this, Dr. Caroline Dale from the University of Liverpool highlighted the value of medication data as a novel lens to understand clinical care beyond traditional outcomes. “Medications capture both direct disease management and indirect health system effects, such as disruptions caused by COVID-19,” she explained. “Linking prescribing data with outcomes will in future enable us to assess not only what drugs are used but critically, how well they work in the real world.”
The study’s authors advocate for continued expansion of linked data infrastructures beyond primary care. Incorporating secondary and private healthcare prescribing, over-the-counter medicines, and vaccination records would provide a fuller picture of the patient medication journey, including areas like high-cost oncology drugs administered via hospitals. Such comprehensive data fusion will empower regulators like the Medicines and Healthcare products Regulatory Agency (MHRA) and guideline bodies such as NICE to perform dynamic safety and effectiveness monitoring, optimizing therapeutic decision-making in near real-time.
To facilitate ongoing analysis and transparency, the team has developed a publicly accessible dashboard designed for stakeholders across the NHS, regulatory agencies, and research institutions. This tool enables tracking of medication utilization trends, side effect occurrences, and health outcomes through an interactive and secure platform, marking a new era in pharmacoepidemiology and NHS medicine management.
This study’s revelations serve as a pivotal step towards bridging critical knowledge gaps hampering precision medicine and equitable healthcare. By illuminating disparities in medication use, rising polypharmacy concerns, and the pandemic’s long-term reverberations on prescribing, the research underscores the urgent need for sustained data access and integration. Only through such robust, interconnected datasets can health systems truly evolve to meet the complex demands of diverse populations, ensuring medicines fulfill their promise to improve health outcomes at scale.
As the UK faces mounting pressures on healthcare budgets and resources, this research provides a powerful evidence base to drive smarter, safer, and fairer prescribing policies. The ability to monitor medication patterns and their downstream effects in near real-time represents a revolution in health data science, promising to safeguard public health and optimize therapeutic value in an increasingly complex clinical landscape.
Subject of Research: People
Article Title: Patterns of medication use across society from national primary care dispensing data
News Publication Date: 15-Jun-2026
Web References: DOI: 10.1038/s44360-026-00134-w
References: Not explicitly provided beyond the article and study details.
Image Credits: Not provided.
Keywords: Medication Use, Primary Care, Polypharmacy, Health Inequalities, COVID-19 Pandemic, Electronic Health Records, NHS England, Data Linkage, Health Data Science, Drug Safety, Public Health Policy, Pharmaceutical Surveillance
