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Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis

Authors Mainar AS, Navarro-Artieda R

Received 26 June 2015

Accepted for publication 28 July 2015

Published 30 December 2015 Volume 2016:12 Pages 29—40

DOI https://doi.org/10.2147/NDT.S91227

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Antoni Sicras-Mainar,1 Ruth Navarro-Artieda2

1Research Unit, Badalona Serveis Assistencials SA, 2Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain

Objective: To describe antidepressant (AD) use in the treatment of major depressive disorder during a period of economic crisis.
Patients and methods: This was a retrospective, observational study using population-based databases. Two periods were considered: 1) 2008–2009, precrisis, and 2) 2012–2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment). Patients were followed up for 12 months. The main measures were use (defined daily doses), epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.
Results: In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8%) discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.
Conclusion: Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs.

Keywords:
consumption, antidepressants, economic crisis

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