Prescription patterns of antidepressants: findings from a US claims database

Miléa, D.; Verpillat, Patrice; Guelfucci, F; Toumi, Mondher; Lamure, Michel

doi:10.1185/03007991003772096

Cited by 41 publications

(42 citation statements)

References 13 publications

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“…anxiety disorders, anorexia and bulimia nervosa, ADHD), as well as for physical health problems (e.g. migraine headaches, fibromyalgia, chronic pain) [81]–[83]. We also know that poor physical health can be a risk factor for suicide [84].…”

Section: Discussionmentioning

confidence: 99%

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

et al. 2013

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BackgroundResearch concerning the association between use of antidepressants and incidence of suicide has yielded inconsistent results and is the subject of considerable controversy. The first aim is to describe trends in the use of antidepressants and rates of suicide in Europe, adjusted for gross domestic product, alcohol consumption, unemployment, and divorce. The second aim is to explore if any observed reduction in the rate of suicide in different European countries preceded the trend for increased use of antidepressants.MethodsData were obtained for 29 European countries between 1980 and 2009. Pearson correlations were used to explore the direction and magnitude of associations. Generalized linear mixed models and Poisson regression distribution were used to clarify the effects of antidepressants on suicide rates, while an autoregressive adjusted model was used to test the interaction between antidepressant utilization and suicide over two time periods: 1980–1994 and 1995–2009.FindingsAn inverse correlation was observed in all countries between recorded Standardised Death Rate (SDR) for suicide and antidepressant Defined Daily Dosage (DDD), with the exception of Portugal. Variability was marked in the association between suicide and alcohol, unemployment and divorce, with countries depicting either a positive or a negative correlation with the SDR for suicide. Every unit increase in DDD of an antidepressant per 1000 people per day, adjusted for these confounding factors, reduces the SDR by 0.088. The correlation between DDD and suicide related SDR was negative in both time periods considered, albeit more pronounced between 1980 and 1994.ConclusionsSuicide rates have tended to decrease more in European countries where there has been a greater increase in the use of antidepressants. These findings underline the importance of the appropriate use of antidepressants as part of routine care for people diagnosed with depression, therefore reducing the risk of suicide.

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Section: Discussionmentioning

confidence: 99%

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

et al. 2013

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“…Even among participants without lifetime history of major or minor depression more than two thirds reported having taken prescription psychiatric medications. This finding highlights the growing trends in prescription and use of psychiatric medications, and especially antidepressants, in the USA [14,16,17,52,53], even in the absence of a psychiatric diagnosis [16,54,55]. While some of these individuals may suffer from mild or subthreshold mental health problems, little evidence supports the benefits of antidepressants in these cases [56,57].…”

Section: Discussionmentioning

confidence: 99%

Clinician-Identified Depression in Community Settings: Concordance with Structured-Interview Diagnoses

Mojtabai

2013

Psychother Psychosom

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Background: Relatively little is known about the prevalence and correlates of overdiagnosis of depression in community settings. This study examined the extent to which individuals with clinician-identified depression in the community meet the criteria for DSM-IV major depressive episodes (MDE) and characteristics of these individuals. Methods: In a sample of 5,639 participants with clinician-identified depression drawn from the 2009-2010 United States National Survey of Drug Use and Health, the proportion of participants who met the 12-month MDE criteria, ascertained by a structured interview, and variations in MDE diagnosis across different groups of participants were examined. Mental health profiles and service use of participants who met the MDE criteria were compared to those who did not meet these criteria. Results: Only 38.4% of participants with 12-month clinician-identified depression met the 12-month MDE criteria. Older adults were less likely than younger adults to meet the criteria - only 14.3% of those 65 years old or older met the criteria, whereas participants with more education and those with poorer overall health were more likely to meet the criteria. Participants who did not meet the 12-month MDE criteria reported less distress and impairment in role functioning and used fewer services. A majority of both groups, however, were prescribed and used psychiatric medications. Conclusions: Depression overdiagnosis and overtreatment is common in community settings in the USA. There is a need for improved targeting of diagnosis and treatments of depression and other mental disorders in these settings.

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“…The database includes inpatient and outpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes, Current Procedural Terminology, 4 th edition, and Healthcare Common Procedure Coding System procedure codes and records for reimbursed, dispensed prescriptions. The database has been used in the past for epidemiologic research involving antidepressants (Miller M et al, 2014b; Valuck RJ et al, 2007) including studies describing adults and children initiating antidepressant therapy (Czaja AS and Valuck R, 2012; Milea D et al, 2010). The University of North Carolina Institutional Review Board deemed the study exempt from review.…”

Section: Methodsmentioning

confidence: 99%

Predicting persistence to antidepressant treatment in administrative claims data: Considering the influence of refill delays and prior persistence on other medications

Bushnell

Stürmer

White

et al. 2016

Journal of Affective Disorders

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Background Many patients with major depressive disorder (MDD) who begin antidepressant treatment discontinue use before for six months, the recommended minimum treatment length. This study sought to identify predictors of six-month antidepressant persistence including predictors utilizing patients’ electronic prescription records. Methods Commercially insured children (3–17 years) and adults (18–64 years) with MDD who initiated antidepressant treatment, 1/1/2003–2/28/2010, were assessed for six-month persistence (based on prescriptions’ days supply, allowing a 30-day grace period). Antidepressant persistence prediction models were developed separately for children and adults. Two additional measures, days without medication between the first and second antidepressant fill (children and adults) and prior persistence on other medications (adults only), were added to the models, concordance (c) statistics were compared and risk reclassification evaluated. Results Among children (n=8,837 children) and adults (n=47,495) with MDD, six-month antidepressant persistence was low and varied by age (37%, 18–24 years to 52%, 3–12 and 50–64 years, respectively). Independent baseline predictors of persistence were identified, with model c-statistics: children=0.582, adults=0.584. Patients with more days without medication between fills were less likely to be persistent (10–30 vs. 0 days, children: RR=0.72, adults: RR=0.74), as were adults not previously persistent to other medications (RR=0.73). Limitations The definition of 6-month persistence is dependent on correct days supply values and the grace period utilized; potential predictors were limited to measures available in claims data. Conclusions Six-month antidepressant persistence was low and overall prediction of persistence was poor; however, days without medication between fills and prior persistence on other medications marginally improved the ability to predict antidepressant persistence.

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Prescription patterns of antidepressants: findings from a US claims database

Cited by 41 publications

References 13 publications

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

Clinician-Identified Depression in Community Settings: Concordance with Structured-Interview Diagnoses

Predicting persistence to antidepressant treatment in administrative claims data: Considering the influence of refill delays and prior persistence on other medications

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