Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications

TY - JOUR

T1 - Antidepressant prescribing in five European countries

T2 - application of common definitions to assess the prevalence, clinical observations, and methodological implications

AU - Abbing-Karahagopian, V

AU - Huerta, C

AU - Souverein, P C

AU - de Abajo, F

AU - Leufkens, H G M

AU - Slattery, J

AU - Alvarez, Y

AU - Miret, M

AU - Gil, M

AU - Oliva, B

AU - Hesse, U

AU - Requena, G

AU - de Vries, F

AU - Rottenkolber, M

AU - Schmiedl, S

AU - Reynolds, R

AU - Schlienger, R G

AU - de Groot, M C H

AU - Klungel, O H

AU - van Staa, T P

AU - van Dijk, L

AU - Egberts, A C G

AU - Gardarsdottir, H

AU - De Bruin, M L

PY - 2014/4

Y1 - 2014/4

N2 - PURPOSE: 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.METHODS: 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.RESULTS: 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).CONCLUSION: 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.

AB - PURPOSE: 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.METHODS: 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.RESULTS: 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).CONCLUSION: 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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antidepressive Agents

KW - Drug Prescriptions

KW - Drug Utilization Review

KW - Europe

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Practice Patterns, Physicians'

KW - Time Factors

KW - Comparative Study

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1007/s00228-014-1676-z

DO - 10.1007/s00228-014-1676-z

M3 - Journal article

C2 - 24793010

SN - 0031-6970

VL - 70

SP - 849

EP - 857

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

IS - 7

ER -