Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications
Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications
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DOI：
10.1007/s00228-014-1676-z
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发表时间：
2014-07-01
影响因子：
2.9
通讯作者：
De Bruin, M. L.
中科院分区：
文献类型：
--
作者：
Abbing-Karahagopian, V.;Huerta, C.;De Bruin, M. L.
药物利用研究对不同的数据类型应用了不同的方法来描述药物使用，这阻碍了跨人群的比较。这项研究的目的是描述七个欧洲电子医疗保健数据库在过去十年中抗抑郁药处方的时间趋势以及以统一方式计算的流行率的变化。2001年至2009年的每万人年流行率(Pys)是在西班牙、德国、丹麦、英国(UK)和荷兰的数据库中计算的。根据年龄、性别、抗抑郁药类型(选择性5-羟色胺再摄取抑制剂[SSRIs]或三环类抗抑郁药[TCA])和主要指标对患病率进行分层。2008年，年龄和性别标准化患病率在两个荷兰最低(每10,000 Py使用391人和429人)，在两个英国最高(每10,000 Pys使用913和936人)。在丹麦、德国和西班牙人群中的流行率分别为每10,000名用户中有637、618和644名用户。与其他人群相比，这两个英国人群中20至60岁的人服用抗抑郁药的频率最高。除德国人外，在所有人群中，SSRI的处方频率都高于TCA。在大多数国家，随着时间的推移，我们观察到抗抑郁药处方的增加趋势。两种不同的方法识别记录的适应症得出了不同范围的特定适应症患者的比例(分别为抑郁症的15%-57%和39%-69%)。尽管采用统一的方法，但不同人群的抗抑郁药处方流行率存在明显差异。数据库特征和临床因素都可以解释这些差异。
Drug utilization studies have applied different methods to various data types to describe medication use, which hampers comparisons across populations. The aim of this study was to describe the time trends in antidepressant prescribing in the last decade and the variation in the prevalence, calculated in a uniform manner, in seven European electronic healthcare databases.Annual prevalence per 10,000 person-years (PYs) was calculated for 2001-2009 in databases from Spain, Germany, Denmark, the United Kingdom (UK), and the Netherlands. Prevalence data were stratified according to age, sex, antidepressant type (selective serotonin re-uptake inhibitors [SSRIs] or tricyclic antidepressants [TCAs]) and major indications.The age- and sex-standardized prevalence was lowest in the two Dutch (391 and 429 users per 10,000 PYs) and highest in the two UK (913 and 936 users per 10,000 PYs) populations in 2008. The prevalence in the Danish, German, and Spanish populations was 637, 618, and 644 users per 10,000 PY respectively. Antidepressants were prescribed most often in 20- to 60-year-olds in the two UK populations compared with the others. SSRIs were prescribed more often than TCAs in all except the German population. In the majority of countries we observed an increasing trend of antidepressant prescribing over time. Two different methods identifying recorded indications yielded different ranges of proportions of patients recorded with the specific indication (15-57 % and 39-69 % for depression respectively).Despite applying uniform methods, variations in the prevalence of antidepressant prescribing were obvious in the different populations. Database characteristics and clinical factors may both explain these variations.