Higher prescription of antidepressants and/or anxiolytics among chronic obstructive pulmonary disease patients

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is often accompanied by psychiatric problems, such as depression and anxiety, affecting both treatment outcomes and mortality. Evidence for the number of COPD patients using medication for these disorders is sparse. In this study, chronic antidepressant (ATD) and anxiolytic (ANX) drug use – to identify depression and anxiety – among COPD patients was compared with subjects with or without other chronic diseases. Methods: The NControl database containing prescription data of 800 pharmacies including 7 million individuals in The Netherlands was used. Patients of age 55+ years who received frequent prescriptions – at least two/year in 5 out of 6 years – for COPD medication, dermatological drugs, disease-modifying antirheumatic drugs (DMARDs), statins and oral glucose-lowering medication were analyzed for concomitant chronic use of ATDs and ANXs between 1 January 2013 and 1 January 2019. All other subjects aged 55+ years were included as a control group (control group 1). This group was further stratified into a group of subjects that received frequent prescriptions of any kind (control group 2). Results: 15.2% of the patients that receive COPD treatment ( n = 96,319), 15.3% of subjects that are treated for dermatological problems ( n = 62,865), 13.2% of subjects that receive DMARDs ( n = 7900), 11.6% of statins users ( n = 422,376) and 11.4% of oral glucose-lowering medication users ( n = 165,975) are also chronically treated for depression or anxiety, compared with 2.6% (control group 1; n = 3,290,608) and 11.4% (control group 2; n = 757,947). In general, female and 75+ years aged subjects showed a higher risk for using ATDs and ANXs chronically. In the COPD and the dermatological patient group the risk was the highest compared with the other patient groups. Conclusions: The rates of chronic ATD and ANX use and the risk of having depression and/or anxiety are especially high in COPD patients, indicating that psychiatric problems are more common in COPD than in most other chronic diseases. In general, age and gender strongly influence the risk of chronically using ATDs and ANXs. The reviews of this paper are available via the supplemental material section.

Exploring the relationship between education, living environment, and anxiety/depression among stable patients: insights from the COPD-AD China Registry study

“…This suggested the protective effect of education against anxiety and depression may be in uenced by other social-contextual variables. Although researches have suggested that systemic in ammation, gender, smoking, acute exacerbation of COPD, hypoxemia, and disease knowledge level were risk factors for anxiety and depression symptoms among patients with COPD [1,10,11]. However, few studies have examined the independent and combined effects of education and living environment on mental health among patients with COPD.…”