Prevalence and variation in antidepressant prescribing across Northern Ireland: a longitudinal administrative data linkage study for targeted support.

北爱尔兰抗抑郁药处方的患病率和变化：针对有针对性的支持的纵向行政数据关联研究。

• 批准号: ES/N012216/1
• 负责人: Mark Shevlin
• 金额: $ 17.45万
• 依托单位: University of Ulster
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FN012216%2F1
• 关键词: Prevalence; variation; antidepressant; prescribing; across

Anti-depressant prescription rates in the United Kingdom (UK) are among the highest in Western Europe and prescription rates in Northern Ireland (NI) are significantly higher than the rest of the UK. Moreover, while prescription rates are climbing annually, rates of depression are not changing, and evidence suggests that a range of socio-economic and geographical factors may be responsible. Furthermore, the majority of UK GP's often believe that alternative treatments may be more appropriate and that they would prescribe antidepressants less frequently if other options were available. Evidence seems to indicate generally that (a) there are widely different reasons why people receive anti-depressants and why GP's prescribe them, and (b) the relative importance of these reasons may vary geographically (e.g. the likelihood of receiving antidepressants may vary due to the affluence of an area or the number and proximity of available primary care services; and the associated pressures on these services).A multi-disciplinary team of experienced academic researchers and the award winning NI charity, Aware Defeat Depression (Aware), aim to maximise the use of Census and Enhanced Prescribing Database data in NI to target, tailor and implement support for individuals in receipt of antidepressant prescriptions and to stimulate 'social prescribing' across the region (a mechanism for linking patients with non-medical sources of support within the community). Specifically the study aims to (i) provide a detailed geographical breakdown of antidepressant prescribing in NI to identify prescription 'hot spots' at a small geographical level, (ii) use linked census data to identify demographic variables (personal, social, and economic factors) that differentiate 'hot spots', (iii) determine if the association between demographic variables and 'hot spots' differs by geographical location, (iv) determine if long-term changes in people's lives (e.g. change in deprivation, family structure, physical health) are associated with antidepressant use and (v) stimulate 'social prescribing' across the region through targeted intervention.The project will address two main research questions highlighted in the 2015/16 ESRC strategic priority area 'Influencing Behaviour and Informing Intervention'.On the basis of the proposed analytic strategy the project team aims to develop a nationwide map detailing the socio-economic landscape of antidepressant prescribing in NI. This map will support the non-academic partners (Aware) in their efforts to develop and implement effective and coordinated intervention programs by (i) highlighting prescription hotspots at a small geographical level (ii) generating 'risk' profiles specific to identified hotspots using personal, social and economic data and (iii) identifying 'vulnerability' at a personal, social and economic level through longitudinal change modelling. The project has the potential to deliver effective and meaningful change. Partnership with Aware will ensure that findings can be acted upon immediately. Aware has been delivering intensive education and training programmes to thousands of adolescents and adults across NI since 1996 and has been awarded the GSK IMPACT Award in 2014. A primary focus of these programmes is to educate individuals about positive strategies that can be used in the recovery from depression. Aware, on the basis of the project findings, will tailor, target and promote 'social prescribing' in those areas and among those individuals in NI that need it most. Social prescribing may include opportunities for arts and creativity, physical activity, learning new skills, volunteering, mutual aid, befriending and self-help, as well as support with, e.g. employment, housing, debt, or parenting problems. Equipped with a detailed geographical map the project team will develop a targeted intervention strategy for delivering focussed, context sensitive social prescribing across NI.

联合王国（UK）的抗癫痫处方率在西欧是最高的，北方爱尔兰（NI）的处方率明显高于联合王国其他地区。此外，虽然处方率每年都在攀升，但抑郁症的发病率并没有变化，有证据表明，一系列社会经济和地理因素可能是原因。此外，大多数英国全科医生往往认为，替代治疗可能更合适，如果有其他选择，他们会减少开抗抑郁药的频率。证据似乎普遍表明：（a）人们接受抗抑郁药和全科医生开抗抑郁药的原因有很大的不同，（B）这些原因的相对重要性可能因地理位置而异（例如，接受抗抑郁药物的可能性可能会因地区的富裕程度或现有基层医疗服务的数量和距离而有所不同;以及这些服务面临的相关压力）。由经验丰富的学术研究人员组成的多学科团队和屡获殊荣的NI慈善机构Aware Defeat Depression（Aware）旨在最大限度地利用NI的人口普查和增强处方数据库数据来瞄准，为接受抗抑郁药处方的个人量身定制并提供支持，并在整个区域鼓励“社会处方”（一种将患者与社区内的非医疗支持来源联系起来的机制）。具体而言，该研究旨在（i）提供NI中抗抑郁药处方的详细地理分类，以确定小地理水平的处方“热点”，（ii）使用相关的人口普查数据来确定人口统计学变量（iii）确定人口统计变量和“热点”之间的关联是否因地理位置而不同，（四）确定人们生活的长期变化（例如贫困、家庭结构、身体健康）与抗抑郁药的使用有关，以及（v）通过有针对性的干预措施在整个地区刺激“社会处方”。该项目将解决2015年/2016年全球抗抑郁药研究报告中强调的两个主要研究问题。16 ESRC战略优先领域“影响行为和提供信息的干预”：在拟议分析战略的基础上，项目小组旨在绘制一份全国地图，详细说明NI抗抑郁药处方的社会经济状况。该地图将支持非学术合作伙伴（Aware）努力制定和实施有效和协调的干预方案，方法是：（一）在小的地理范围内突出处方热点;（二）使用个人、社会和经济数据生成特定于已确定热点的“风险”概况;（三）通过纵向变化建模确定个人、社会和经济层面的“脆弱性”。该项目有可能带来有效和有意义的变化。与Aware的伙伴关系将确保可以立即对调查结果采取行动。自1996年以来，Aware一直在为北爱尔兰数千名青少年和成年人提供强化教育和培训计划，并于2014年获得GSK IMPACT奖。这些方案的一个主要重点是教育个人了解可用于从抑郁症中恢复的积极策略。Aware将根据项目调查结果，在北爱尔兰最需要的地区和个人中调整、瞄准和促进“社会处方”。社会处方可能包括艺术和创造力的机会，体育活动，学习新技能，志愿服务，互助，交友和自助，以及支持，例如就业，住房，债务或养育问题。配备了详细的地理地图，项目团队将制定一个有针对性的干预策略，在整个NI提供集中的，对环境敏感的社会处方。

项目成果

Prevalence and predictors of antidepressant prescribing in Northern Ireland

北爱尔兰抗抑郁药处方的患病率和预测因素

• DOI: 10.23889/ijpds.v3i2.567
• 发表时间: 2018
• 期刊: International Journal of Population Data Science
• 作者: Shevlin M