初级保健中抗抑郁药的过度使用:加泰罗尼亚2010年至2019年的处方趋势。

IF 5.2 3区 医学 Q1 PSYCHIATRY
Gerard Anmella, Miriam Sanabra, Mireia Primé-Tous, Xavier Segú, Aleix Solanes, Victoria Ruíz, Ivette Morilla, Antonieta Also Fontanet, Elisenda Sant, Sandra Murgui, Mireia Sans-Corrales, Anabel Martínez-Aran, Giovanna Fico, Michele De Prisco, Vincenzo Oliva, Andrea Murru, Roland Zahn, Allan H Young, Victor Vicens, Clara Viñas-Bardolet, Vicenç Aparicio-Nogué, Juan Francisco Martínez-Cerdá, Ariadna Mas, Bernat Carreras, Jordi Blanch, Joaquim Radua, Miquel A Fullana, Myriam Cavero, Eduard Vieta, Diego Hidalgo-Mazzei
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引用次数: 2

摘要

引言:在初级保健(PC)中,抗抑郁药(AD)的处方有所增加。然而,尚不清楚这是否是由AD适应症诊断的增加所解释的。我们调查了西班牙加泰罗尼亚与AD处方相关的频率和变量的变化。方法:我们检索了AD处方、社会人口学、,以及使用2010年至2019年间参加PC的人群代表性样本(N=947.698)的个人电子健康记录的健康相关数据。AD的处方使用DHD(每1000名居民/天的定义每日剂量)计算。我们比较了研究期间DHD的累积变化与AD指征诊断的累积变化。我们使用泊松回归来检验与AD处方相关的社会人口统计学和健康相关变量。结果:AD处方和有AD指征的心理健康诊断均逐渐增加。在研究期结束时,AD处方和有AD指征的心理健康诊断的DHD分别累计增加了404%和49%。女性(发病率比率(IRR)=2.83)、年龄较大(IRR=25.43),和较低的社会经济地位(IRR=1.35)与开AD的风险增加显著相关。结论:我们对一个具有代表性的大型患者队列的研究结果证实了AD处方的稳步增加,而这并不是由精神健康诊断与AD指征的平行增加所解释的。从这种分离可以推断出加泰罗尼亚PC系统中AD标签外和过量处方的趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia.

Introduction: There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain.

Methods: We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription.

Results: Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD.

Conclusions: Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.

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来源期刊
自引率
3.30%
发文量
58
期刊介绍: The Spanish Journal of Psychiatry and Mental Health (SJPMH), incorporated into ISSN 1888-9891, is the official scientific publication of the Spanish Society of Psychiatry and Mental Health. The journal focuses on studying mental illnesses, their pathological processes, and their psychosocial consequences, and aims to disseminate scientific advances in all areas related to mental health and illness. SJPMH accepts unpublished works on psychiatry and mental health, including their medical and social implications. The journal provides space for research in the biological, clinical, and psychosocial fields. Manuscripts undergo peer-review by external reviewers before being accepted for publication. SJPMH is indexed in Index Medicus/Medline, IBECS, Social Sciences Citation Index Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Sciences.
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