Indications for antidepressant drug prescribing in general practice in the Netherlands
Indications for antidepressant drug prescribing in general practice in the Netherlands
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DOI：
10.1016/j.jad.2006.07.003
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发表时间：
2007-02-01
影响因子：
6.6
通讯作者：
Egberts, A. C. G.
中科院分区：
文献类型：
--
作者：
Gardarsdottir, H.;Heerdink, E. R.;Egberts, A. C. G.
背景：目前，使用包含处方数据的数据库可以相对容易地估计大量人群使用抗抑郁药的强度。使用处方数据库有缺点，因为它们不包含患者疾病的临床数据。抗抑郁药是针对不同的疾病开出的处方，因此关于适应症的信息可以帮助解释抗抑郁药使用数据库研究的结果。这项研究的目的是调查在荷兰，抗抑郁药是针对哪些适应症开处方的。方法：数据来自由NIVEL （N-385,461）开展的第二次荷兰全国全科医学调查。选取2001年接受全科医生开具抗抑郁药处方的18岁及以上患者（N = 13,835）。使用不同长度的时间窗确定抗抑郁药物处方的适应症。结果：抗抑郁药最常用于抑郁症（45.5%）和焦虑/惊恐障碍（17.2%）。对于这些适应症，将处方日期前后的时间窗口从0天延长至180天，导致具有这些适应症的抗抑郁药物使用者增加20-40%。局限性：我们所选择的适应症在约三分之一的抗抑郁药物使用者的医患联系档案中没有被确定。这项研究是在一般的实践环境中进行的，不包括咨询精神科医生的抗抑郁药使用者。结论：全科医生开抗抑郁药主要用于治疗抑郁症。然而，使用抗抑郁药物作为在处方数据库中识别抑郁症患者的代理应该谨慎行事，并在可能的情况下与临床数据相结合。(c) 2006 Elsevier B.V.版权所有
Background: The intensity of the use of antidepressants in large populations can nowadays relatively easily be estimated using databases encompassing prescription data. There are shortcomings when using prescription databases as they contain no clinical data on patient illness. Antidepressants are prescribed for different illnesses, thus information on the indications could help when interpreting results from database studies on antidepressant drug use. The aim of this study is to investigate for which indications antidepressants are being prescribed in general practice in the Netherlands.Methods: Data were obtained from the Second Dutch National Survey of General Practice, carried out by NIVEL (N-385,461). Patients, 18 years and older, who received an antidepressant prescription from a general practitioner in 2001 were selected (N = 13,835). Indications for antidepressant drug prescribing were identified using time windows of different lengths.Results: Antidepressants are most often being prescribed for depression (45.5%) and anxiety/panic disorders (17.2%). For these indications lengthening the time window around prescription date from 0 to 180 days resulted in an increase of 20-40% in antidepressant drug users identified with these indications.Limitution: None of our selected indications could be identified in the physician-patient contact file for about a third of the antidepressant drug users. The study was performed in a general practice setting and did not include antidepressant users who consult psychiatrists.Conclusion: GPs prescribe antidepressants predominantly for treating depression. However, using antidepressant drug as a proxy for identifying depressed patients in a prescription database Should be done with caution and when possible in combination with clinical data. (c) 2006 Elsevier B.V. All rights reserved.