Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia

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

doi:10.1016/j.rpsm.2022.12.001

Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia

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-BardoletVicenç 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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Abstract

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.

Original language	English
Journal	Revista de Psiquiatria y Salud Mental
Early online date	14 Dec 2022
DOIs	https://doi.org/10.1016/j.rpsm.2022.12.001
Publication status	E-pub ahead of print - 14 Dec 2022

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Anmella, G., Sanabra, M., Primé-Tous, M., Segú, X., Solanes, A., Ruíz, V., Morilla, I., Also Fontanet, A., Sant, E., Murgui, S., Sans-Corrales, M., Martínez-Aran, A., Fico, G., De Prisco, M., Oliva, V., Murru, A., Zahn, R., Young, A. H., Vicens, V., ... Hidalgo-Mazzei, D. (2022). Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia. Revista de Psiquiatria y Salud Mental. Advance online publication. https://doi.org/10.1016/j.rpsm.2022.12.001

@article{bd1a6e5f32b341df92119989a044f834,

title = "Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia",

abstract = "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.",

author = "Gerard Anmella and Miriam Sanabra and Mireia Prim{\'e}-Tous and Xavier Seg{\'u} and Aleix Solanes and Victoria Ru{\'i}z and Ivette Morilla and {Also Fontanet}, Antonieta and Elisenda Sant and Sandra Murgui and Mireia Sans-Corrales and Anabel Mart{\'i}nez-Aran and Giovanna Fico and {De Prisco}, Michele and Vincenzo Oliva and Andrea Murru and Roland Zahn and Young, {Allan H} and Victor Vicens and Clara Vi{\~n}as-Bardolet and Vicen{\c c} Aparicio-Nogu{\'e} and Mart{\'i}nez-Cerd{\'a}, {Juan Francisco} and Ariadna Mas and Bernat Carreras and Jordi Blanch and Joaquim Radua and Fullana, {Miquel A} and Myriam Cavero and Eduard Vieta and Diego Hidalgo-Mazzei",

year = "2022",

month = dec,

day = "14",

doi = "10.1016/j.rpsm.2022.12.001",

language = "English",

journal = "Revista de Psiquiatria y Salud Mental",

issn = "1888-9891",

publisher = "Ediciones Doyma, S.L.",

}

Anmella, G, Sanabra, M, Primé-Tous, M, Segú, X, Solanes, A, Ruíz, V, Morilla, I, Also Fontanet, A, Sant, E, Murgui, S, Sans-Corrales, M, Martínez-Aran, A, Fico, G, De Prisco, M, Oliva, V, Murru, A, Zahn, R , Young, AH, Vicens, V, Viñas-Bardolet, C, Aparicio-Nogué, V, Martínez-Cerdá, JF, Mas, A, Carreras, B, Blanch, J, Radua, J, Fullana, MA, Cavero, M, Vieta, E & Hidalgo-Mazzei, D 2022, 'Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia', Revista de Psiquiatria y Salud Mental. https://doi.org/10.1016/j.rpsm.2022.12.001

TY - JOUR

T1 - Antidepressants overuse in primary care

T2 - Prescription trends between 2010 and 2019 in Catalonia

AU - Anmella, Gerard

AU - Sanabra, Miriam

AU - Primé-Tous, Mireia

AU - Segú, Xavier

AU - Solanes, Aleix

AU - Ruíz, Victoria

AU - Morilla, Ivette

AU - Also Fontanet, Antonieta

AU - Sant, Elisenda

AU - Murgui, Sandra

AU - Sans-Corrales, Mireia

AU - Martínez-Aran, Anabel

AU - Fico, Giovanna

AU - De Prisco, Michele

AU - Oliva, Vincenzo

AU - Murru, Andrea

AU - Zahn, Roland

AU - Young, Allan H

AU - Vicens, Victor

AU - Viñas-Bardolet, Clara

AU - Aparicio-Nogué, Vicenç

AU - Martínez-Cerdá, Juan Francisco

AU - Mas, Ariadna

AU - Carreras, Bernat

AU - Blanch, Jordi

AU - Radua, Joaquim

AU - Fullana, Miquel A

AU - Cavero, Myriam

AU - Vieta, Eduard

AU - Hidalgo-Mazzei, Diego

PY - 2022/12/14

Y1 - 2022/12/14

N2 - 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.

AB - 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.

U2 - 10.1016/j.rpsm.2022.12.001

DO - 10.1016/j.rpsm.2022.12.001

M3 - Article

C2 - 37758595

SN - 1888-9891

JO - Revista de Psiquiatria y Salud Mental

JF - Revista de Psiquiatria y Salud Mental

ER -

Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia

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