Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T08:14:15.755Z Has data issue: false hasContentIssue false
  • English
  • Français

Duration and adherence of antidepressant treatment (2003 to 2007) based on prescription database*

Published online by Cambridge University Press:  16 April 2020

M.C. Serna ,
I. Cruz ,
J. Real ,
E. Gascó  and
L. Galván
M.C. Serna
Affiliation:
University of Lleida, Lleida, Spain Regional Primary Care Management Office, Catalan Institute of Health, Lleida, Spain
I. Cruz
Affiliation:
Primary Care Research Institute, IDIAP Jordi Gol, Catalan Institute of Health, Lleida, Spain Ronda Health Center, Catalan Institute of Health, Lleida, Spain
J. Real*
Affiliation:
University of Lleida, Lleida, Spain Primary Care Research Institute, IDIAP Jordi Gol, Catalan Institute of Health, Lleida, Spain
E. Gascó
Affiliation:
Ronda Health Center, Catalan Institute of Health, Lleida, Spain
L. Galván
Affiliation:
Catalan Health Department, Lleida, Spain
*
*Corresponding author. Unitat de Suport a la Recerca. Àmbit Atenció Primària Lleida, IDIAP Jordi Gol–ICS, Lleida, Spain. Tel.: +0034-973 728293. E-mail address: jreal.lleida.ics@gencat.cat (J. Real).
Get access

Abstract

Background

Many patients discontinue antidepressant therapy long before the six-month minimum duration recommended for the treatment of major depression and many other diagnoses.

Purpose

To estimate the duration of antidepressant treatment and to analyse the following factors in relation to treatment adherence: age, sex, polypharmacy and type of drug.

Methods

Retrospective cohort followed up for five years (2003–2007) based on prescription database. Selection criteria: Users who had received at least one antidepressant prescription in 2003 and who had not received antidepressants during the previous 12 months.

Variables studied

Age, sex, drug, polypharmacy, period of treatment, packs dispensed. Adequate adherence was defined as dispensation of medication during at least 80% of the treatment period, and compliance was defined as good when, in addition, the treatment lasted more than four months.

Results

Of the 7525 patients selected, 56% abandoned medication during the first four months. Men were more likely to give up medication before time than women. Good compliance was recorded in 22% of patients and was twice as frequent in patients with high levels of polypharmacy than in those with low levels (31% vs. 15.3%). Patients receiving maprotiline, venlafaxine, mirtazapine, citalopram, clomipramine and fluoxetine presented the highest percentages of good compliance.

Conclusions

Only one out of five patients complied with treatment for over four months. Treatment periods were shorter in men. In chronic processes, patients receiving polypharmacy presented the best compliance.

Keywords

AntidepressantDrug utilization reviewMedication adherencePrescribingPrimary careTreatment
Type
Original article
Information
European Psychiatry , Volume 25 , Issue 4 , May 2010 , pp. 206 - 213
Copyright
Copyright © Elsevier Masson SAS 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

These authors contributed equally to this work.

References

Agency for health care policy research. Treatment of major depression. Clin Pract Guidel 1993;l2:5 [Rockville, Md, US Department of health and human services].Google Scholar
Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H.et al.Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004; 420: 55–64.Google Scholar
American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry 2000;157:1–45.Google Scholar
Antoñanzas, F.Challenges to achieving value in drug spending in a decentralized country: the Spanish case. Value Health 2003; 6: S52–S63.CrossRefGoogle Scholar
De Las Cuevas, C., Sanz, E.Do therapeutic indications of antidepressants change from one year to another?. Pharmacoepidemiol Drug Saf 2004; 13: 309–314.CrossRefGoogle Scholar
Frank, E.Enhancing patient outcomes: treatment adherence. J Clin Psychiatry. 1997; 58(Suppl 1): 11–14.Google ScholarPubMed
Gardarsdottir, H., Veffen, E.C.G., Stolker, J.J., Egberts, T.C.G., Heerdink, E.R.Does the length of the first antidepressant treatment episode influence risk and time to a second episode. J Clin Psychopharmacol 2009; 29: 69–72.CrossRefGoogle ScholarPubMed
Gartlehner, G., Gaynes, B.N., Hansen, R.A., Thieda, P., DeVeaugh-Geiss, A., Krebs, E.E.et al.Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians. Ann Intern Med. 2008; 149(10): 734–750.CrossRefGoogle ScholarPubMed
Gartlehner, G, Hansen, RA, Thieda, P, DeVeaugh-Geiss, AM, Gaynes, BN, Krebs, EE, et al.Comparative effectiveness of second-generation antidepressants in the pharmacologic treatment of adult depression. Comparative effectiveness review No.7-EHC007-EF. Rockville, MC: Agency for Healthcare Research and Quality; 2007 .Accessed at: http://www.effectivehealthcare.ahrq.gov/reports/final.cfm on 30 September 2008.Google Scholar
Geddes, J.R., Carney, S.M., Davies, C., Furukawa, T.A., Kupfer, D.J., Frank, E.et al.Relapse prevention with antidepressant drug treatment in depressive disorders. Lancet 2003; 361: 653–651.CrossRefGoogle ScholarPubMed
Haider, S.I., Johnell, K., Weitoft, G.R., Thorslund, M., Fastbom, J.The influence of educational level on polypharmacy and inappropriate drug use: a register-based study of more than 600,000 older people. J Am Geriatr Soc. 2009; 57(1): 62–69.CrossRefGoogle ScholarPubMed
Keller, M.B., Hirschfeld, R.M.A., Kemyyenaere, K., Baldwin, D.S.Optimizing outcomes in depression: focus on antidepressant compliance. Int Clin Psychopharmacol 2002; 17: 265–271.CrossRefGoogle ScholarPubMed
Kirsch, I., Deacon, B.J., Huedo-Medina, T.B., Scoboria, A., Moore, T.J., Johnson, B.T.Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5: e45.CrossRefGoogle ScholarPubMed
Ley 14/1986 de 25 de abril, Ley General de Sanidad, BOE núm.112 de 24/86.Google Scholar
Licht-Struk, E., van der Windt, D.A.W.M., van Marwijk, H.W.J., de Haan, M., Beekman, A.T.F.The prognosis of depression in older patients in general practice and the community. A systematic rexiew. Fam Pract 2007; 24: 168–180.CrossRefGoogle Scholar
Meijer, W.E., Heerdink, E.R., Leufkens, H.G., Herings, R.M., Egberts, A.C., Nolen, W.A.Incidence and determinants of long-term use of antidepressants. Eur J Clin Pharmacol 2004; 60: 57–61.CrossRefGoogle ScholarPubMed
Melfi, C.A.Using databases for studying and comparing health care costs and resource use. Pharmacoepidemiol Drug Saf 2001; 10: 399–402.CrossRefGoogle ScholarPubMed
Morishita, S., Arita, S.Differential effects of ilnacipran, fluvoxamine and paroxetine for depression, especially in gender. Eur Psychiatry 2003; 18: 418–420.CrossRefGoogle ScholarPubMed
National Association of State Mental Health Program Directors, Medical Directors Council and State Medicaid Directors. NASMHPD Medical Directors.Technical. Report on Psychiatric Polypharmacy. Alexandria; 2001.Google Scholar
Nomenclator digitalis. Madrid: INSALUD; 2002.Google Scholar
Olfson, M., Marcus, S., Tedeschi, M., Wan, G.Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry 2006; 163: 101–108.CrossRefGoogle ScholarPubMed
Pomerantz, J.M., Finkelstein, S.N., Berndt, E.R., Poret, A.W., Walker, L.E., Alber, R.C.Prescriber intent, off-label usage, and early discontinuation of antidepressants: a retrospective physician survey and data analysis. J Clin Psychiatry 2004; 65: 395–404.CrossRefGoogle ScholarPubMed
Robinson, R.L., Long, S.R., Chang, S., Able, S., Baser, O., Obenchain, R.L.et al.Higher costs and therapeutic factors associated with adherence to NCQA HEDIS antidepressant medication management measures: analysis of administrative claims. J Manag Care Pharm. 2006; 12(1): 43–54.Google ScholarPubMed
Rush, A.J., Trivedi, M.H., Wisniewski, S.R., Stewart, J.W., Nierenberg, A.A., Thase, M.E.et al.Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N Engl J Med 2006; 354: 1231–1242.CrossRefGoogle ScholarPubMed
Simon, G., Vonkorff, M., Wagner, E.H., Barlow, W.Patterns of antidepressant use in community practice. Gen Hosp Psychiatry 1993; 15: 399–408.CrossRefGoogle ScholarPubMed
Thase, M.E., Entsuah, R., Cantillon, M., Kornstein, S.G.Relative antidepressant efficacy of venlafaxine and SSRIs: sex-age interactions. J Womens Health (Larchmt) 2005; 14: 609–616.CrossRefGoogle ScholarPubMed
Turner, E.H., Matthews, A.M., Linardatos, E., Tell, R.A., Rosenthal, R.Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 2008; 358: 252–260.CrossRefGoogle ScholarPubMed
Vanelli, M., Coca-Perraillon, M.Role of patient experience in antidepressant adherence. A retrospective data analysis. Clin Ther 2008; 30: 1737–1745.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.