Trends in patterns of antidepressant use in older general population between 2006 and 2012 following publication of practice guidelines

Etchepare, Fanny; Pambrun, Élodie; Verdoux, Hélène; Tournier, Marie

doi:10.1002/gps.4536

Cited by 10 publications

(4 citation statements)

References 21 publications

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“…Reduced efficacy or higher toxicity due to interindividual variability contributes to treatment failure or noncompliance. Approximately 62% of the depressive patients were reported to show no effective response to their treatment …”

Section: Highlights Of Ethnic Differences On Allele Frequencies Of Mamentioning

confidence: 99%

A Study on CYP2C19 and CYP2D6 Polymorphic Effects on Pharmacokinetics and Pharmacodynamics of Amitriptyline in Healthy Koreans

Sungpil

Park

et al. 2017

Clinical Translational Sci

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We performed a double‐blinded, genotype‐based stratification study to explore the pharmacokinetics and pharmacodynamics of amitriptyline according to CYP2C19 and CYP2D6 genotype in Korean subjects. Twenty‐four healthy adults were grouped by genotype of CYP2C19 and CYP2D6. After a single dose of 25 mg of amitriptyline, blood samples were collected and anticholinergic effects were measured. The extent of N‐demethylation of amitriptyline significantly decreased in subjects carrying two nonfunctional alleles of CYP2C19. The extent of hydroxylation of amitriptyline or nortriptyline was significantly reduced in subjects carrying two CYP2D6 decreased functional alleles compared with those with no or one decreased functional allele. The overall metabolic pathway of amitriptyline was more likely to be dominated by CYP2C19 than CYP2D6. The gene variations of CYP2C19 and CYP2D6 did not change the pharmacodynamic effect. The findings of this study will provide useful information on individualized drug treatment with amitriptyline considering both CYP2D6 and CYP2C19 gene variations.

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Section: Highlights Of Ethnic Differences On Allele Frequencies Of Mamentioning

confidence: 99%

A Study on CYP2C19 and CYP2D6 Polymorphic Effects on Pharmacokinetics and Pharmacodynamics of Amitriptyline in Healthy Koreans

Sungpil

Park

et al. 2017

Clinical Translational Sci

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“…9 With the increasing research focus on knowledge translation (KT) and evidence-based medicine (EBM), and the growing importance of the uptake of best evidence into clinical practice, ITS analysis has become a common tool used in assessing the effect of clinical practice guidelines and recommendations. [10][11][12][13][14] For instance, ITS design was used to look at de-adoption of tight glycemic control in critically ill patients across 113 intensive care units (ICUs) in the USA following publication of a randomized trial showing that tight glycemic control can increase mortality. 15 In another study, ITS design was used in evaluating the impact of Otolaryngology Head and Neck Surgery (OHNS) guidelines on perioperative care process and patient outcomes in children undergoing tonsillectomy.…”

Section: Introductionmentioning

confidence: 99%

<p>Methods, Applications and Challenges in the Analysis of Interrupted Time Series Data: A Scoping Review</p>

Ewusie¹,

Soobiah²,

Blondal³

et al. 2020

JMDH

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Objective: Interrupted time series (ITS) designs are robust quasi-experimental designs commonly used to evaluate the impact of interventions and programs implemented in healthcare settings. This scoping review aims to 1) identify and summarize existing methods used in the analysis of ITS studies conducted in health research, 2) elucidate their strengths and limitations, 3) describe their applications in health research and 4) identify any methodological gaps and challenges. Design: Scoping review. Data Sources: Searches were conducted in MEDLINE, JSTOR, PUBMED, EMBASE, CINAHL, Web of Science and the Cochrane Library from inception until September 2017. Study Selection: Studies in health research involving ITS methods or reporting on the application of ITS designs. Data Extraction: Screening of studies was completed independently and in duplicate by two reviewers. One reviewer extracted the data from relevant studies in consultations with a second reviewer. Results of the review were presented with respect to methodological and application areas, and data were summarized using descriptive statistics. Results: A total of 1389 articles were included, of which 98.27% (N=1365) were application papers. Segmented linear regression was the most commonly used method (26%, N=360). A small percentage (1.73%, N=24) were methods papers, of which 11 described either the development of novel methods or improvement of existing methods, 7 adapted methods from other areas of statistics, while 6 provided comparative assessment of conventional ITS methods. Conclusion: A significantly increasing trend in ITS use over time is observed, where its application in health research almost tripled within the last decade. Several statistical methods are available for analyzing ITS data. Researchers should consider the types of data and validate the required assumptions for the various methods. There is a significant methodological gap in ITS analysis involving aggregated data, where analyses involving such data did not account for heterogeneity across patients and hospital settings.

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“…Several studies revealed that only a minority of affected patients is actually treated and that treatment duration is frequently inadequate. 9,14,15 However, it was also reported that antidepressants are often used without justification and that antidepressant prescriptions may be influenced by social factors such as loneliness or by the presence of somatic comorbidities. [16][17][18] A recent review of seniors aged 55 years and older found antidepressant use in only 20% to 45% of persons with depression.…”

Section: Introductionmentioning

confidence: 99%

Evidence for underuse and overuse of antidepressants in older adults: Results of a large population‐based study

Boehlen

Freigofas

Herzog

et al. 2019

Int J Geriat Psychiatry

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Objectives Depression is common among elderly people. However, diagnosis and adequate treatment is frequently difficult. Research on underuse and overuse of antidepressants in elderly persons is scarce. This study investigates the utilization and appropriateness of pharmacological and psychological depression treatment in a large cohort of community‐dwelling adults. Methods A subsample of 3117 participants (aged 55‐85 y) of the third follow‐up (2008‐2010) of the large population‐based German ESTHER study was included. Depression was assessed using the eight‐item Patient Health Questionnaire (PHQ‐8). In the course of a home visit, study doctors collected complete information on medication. Logistic regression analyses were conducted to determine the relationship of depression with both underuse and overuse of antidepressants. The analyses were then adjusted for socioeconomic variables, psychosomatic comorbidities, and motivation to seek help. Results One hundred sixty‐three participants (5.2%; 95% confidence interval [CI], 4.5‐6.1) fulfilled the criteria for major depression. Underuse of antidepressants was present in 126 depressed participants (77.3%; 70.1‐83.5). Persons who were motivated to seek help, who had an established depression diagnosis, or who were taking more than five different medications had lower odds of underuse. Anxiety was associated with higher odds for underuse. Overuse of antidepressants (prescription without clinical indication) was found in 96 cases (41.7%; 35.3‐48.4) of all antidepressant prescriptions. Conclusions Depression treatment in older adults is frequently insufficient; it appears to depend on diagnosis as well as the patients' motivation to seek help. Education regarding the diagnosis of depression in the elderly as well as guidelines for appropriate treatment is needed.

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Trends in patterns of antidepressant use in older general population between 2006 and 2012 following publication of practice guidelines

Cited by 10 publications

References 21 publications

A Study on CYP2C19 and CYP2D6 Polymorphic Effects on Pharmacokinetics and Pharmacodynamics of Amitriptyline in Healthy Koreans

A Study on CYP2C19 and CYP2D6 Polymorphic Effects on Pharmacokinetics and Pharmacodynamics of Amitriptyline in Healthy Koreans

<p>Methods, Applications and Challenges in the Analysis of Interrupted Time Series Data: A Scoping Review</p>

Evidence for underuse and overuse of antidepressants in older adults: Results of a large population‐based study

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