Sobreutilización de antidepresivos en atención primaria: tendencias de prescripción entre 2010-2019 en Cataluña

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

Sobreutilización de antidepresivos en atención primaria: tendencias de prescripción entre 2010-2019 en Cataluña

Translated title of the contribution: 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^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

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.

Translated title of the contribution	Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia
Original language	Spanish
Journal	Revista de psiquiatria y salud mental
DOIs	https://doi.org/10.1016/j.rpsm.2022.12.001
Publication status	Accepted/In press - 2023

Keywords

Antidepressants
Prescription
PRESTO
Primary care

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.rpsm.2022.12.001

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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. (Accepted/In press). Sobreutilización de antidepresivos en atención primaria: tendencias de prescripción entre 2010-2019 en Cataluña. Revista de psiquiatria y salud mental. https://doi.org/10.1016/j.rpsm.2022.12.001

@article{3f27d89a0a744264b96371dd67a703bf,

title = "Sobreutilizaci{\'o}n de antidepresivos en atenci{\'o}n primaria: tendencias de prescripci{\'o}n entre 2010-2019 en Catalu{\~n}a",

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.",

keywords = "Antidepressants, Prescription, PRESTO, Primary care",

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",

note = "Funding Information: This study has been carried out using the anonymized data ceded by the Agency for Health Quality and Assessment of Catalonia (AQuAS), within the framework of the Data Analytics Programme for Health Research and Innovation (PADRIS) ( https://aquas.gencat.cat/ ). The PRESTO project is funded by Fundaci{\'o} Cl{\'i}nic per a la Recerca Biom{\`e}dica through the Pons Bartan 2020 grant (PI046549). Dr. Anmella is supported by a Rio Hortega 2021 grant (CM21/00017) from the Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and co-financed by the Fondo Social Europeo Plus (FSE+). Dr. Sanabra' s research is supported by a grant from Baszucki Brain Research Fund. Dr. Fico is supported by a fellowship from “La Caixa” Foundation (ID 100010434) – fellowship code – LCF/BQ/DR21/11880019. Dr. Martinez-Aran thanks the support of the Spanish Ministry of Science and Innovation (PI18/00789, PI21/00787) integrated into the Plan Nacional de I+D+I and co-financed by ISCIII-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00177. Dr. Vieta thanks the support of the Spanish Ministry of Science, Innovation and Universities (PI15/00283, PI18/00805, PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the Instituto de Salud Carlos III (ISCIII)-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d{\textquoteright}Universitats i Recerca del Departament d{\textquoteright}Economia i Coneixement (2017 SGR 1365), and the CERCA Programme/Generalitat de Catalunya. We would like to thank the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Dr. Murru thanks the support of the Spanish Ministry of Science and Innovation (PI19/00672) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirecci{\'o}n General de Evaluaci{\'o}n and the Fondo Europeo de Desarrollo Regional (FEDER). Dr. Radua is supported by a Miguel Servet Research ContractCPII19/00009 from theInstituto de Salud Carlos III and co-funded by European Union (ERDF/ESF, {\textquoteleft}Investing in your future{\textquoteright}). Dr. Hidalgo-Mazzei 's research is supported by a Juan Rod{\'e}s JR18/00021 granted by the Instituto de Salud Carlos III (ISCIII). We would like to thank the PADRIS Programme for their administrative and statistical support as well as the CERCA Programme, and the Generalitat de Catalunya for the institutional support. Funding Information: This study has been funded by a Pons Bartran 2020 research grant (project PI046549 ). Publisher Copyright: {\textcopyright} 2022 SEP y SEPB",

year = "2023",

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

language = "Spanish",

journal = "Revista de psiquiatria y salud mental",

issn = "1888-9891",

publisher = "Elsevier",

}

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 2023, 'Sobreutilización de antidepresivos en atención primaria: tendencias de prescripción entre 2010-2019 en Cataluña', Revista de psiquiatria y salud mental. https://doi.org/10.1016/j.rpsm.2022.12.001

TY - JOUR

T1 - Sobreutilización de antidepresivos en atención primaria

T2 - tendencias de prescripción entre 2010-2019 en Cataluña

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

N1 - Funding Information: This study has been carried out using the anonymized data ceded by the Agency for Health Quality and Assessment of Catalonia (AQuAS), within the framework of the Data Analytics Programme for Health Research and Innovation (PADRIS) ( https://aquas.gencat.cat/ ). The PRESTO project is funded by Fundació Clínic per a la Recerca Biomèdica through the Pons Bartan 2020 grant (PI046549). Dr. Anmella is supported by a Rio Hortega 2021 grant (CM21/00017) from the Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and co-financed by the Fondo Social Europeo Plus (FSE+). Dr. Sanabra' s research is supported by a grant from Baszucki Brain Research Fund. Dr. Fico is supported by a fellowship from “La Caixa” Foundation (ID 100010434) – fellowship code – LCF/BQ/DR21/11880019. Dr. Martinez-Aran thanks the support of the Spanish Ministry of Science and Innovation (PI18/00789, PI21/00787) integrated into the Plan Nacional de I+D+I and co-financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00177. Dr. Vieta thanks the support of the Spanish Ministry of Science, Innovation and Universities (PI15/00283, PI18/00805, PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the Instituto de Salud Carlos III (ISCIII)-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), and the CERCA Programme/Generalitat de Catalunya. We would like to thank the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Dr. Murru thanks the support of the Spanish Ministry of Science and Innovation (PI19/00672) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER). Dr. Radua is supported by a Miguel Servet Research ContractCPII19/00009 from theInstituto de Salud Carlos III and co-funded by European Union (ERDF/ESF, ‘Investing in your future’). Dr. Hidalgo-Mazzei 's research is supported by a Juan Rodés JR18/00021 granted by the Instituto de Salud Carlos III (ISCIII). We would like to thank the PADRIS Programme for their administrative and statistical support as well as the CERCA Programme, and the Generalitat de Catalunya for the institutional support. Funding Information: This study has been funded by a Pons Bartran 2020 research grant (project PI046549 ). Publisher Copyright: © 2022 SEP y SEPB

PY - 2023

Y1 - 2023

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.

KW - Antidepressants

KW - Prescription

KW - PRESTO

KW - Primary care

UR - http://www.scopus.com/inward/record.url?scp=85145985749&partnerID=8YFLogxK

U2 - 10.1016/j.rpsm.2022.12.001

DO - 10.1016/j.rpsm.2022.12.001

M3 - Article

AN - SCOPUS:85145985749

SN - 1888-9891

JO - Revista de psiquiatria y salud mental

JF - Revista de psiquiatria y salud mental

ER -

Sobreutilización de antidepresivos en atención primaria: tendencias de prescripción entre 2010-2019 en Cataluña

Abstract

Keywords

UN SDGs

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