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Antidepressant treatment patterns in younger and older adults from the general population in a real‐life setting
Author(s) -
Etchepare Fanny,
Sanglier Thibaut,
André Ma,
Verdoux Hélène,
Tournier Marie
Publication year - 2014
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4081
Subject(s) - antidepressant , gerontology , population , medicine , psychology , psychiatry , anxiety , environmental health
Objective The treatment of depression in real‐life settings appears to be influenced by health care systems. Antidepressant drugs have been found to be underused in the older population relative to younger adults when refunding of such drugs is poor. No study assessed the pattern of antidepressant use according to age in a universal health care system. The objective is to assess whether the pattern of antidepressant drug use differs between younger and older adults with respect to treatment duration, adherence to treatment, coprescription of other psychotropic drugs, switch, or combination of antidepressant drugs. Methods A historical cohort study included 7747 older (65+ years) and 27 306 younger (younger than 65 years) adults representative of the beneficiaries of the French national health care insurance system who initiated a new antidepressant treatment. Follow‐up after treatment initiation was at least 6 months. Results Older patients had a significantly longer duration of treatment than younger adults (hazard ratio = 0.90; 95%CI[0.88–0.93]). Adherence was more often good in older than in younger adults when the treatment was initiated by a general practitioner (23.4% vs. 16.7%; Odds ratio (OR) = 1.35[1.25–1.46]), a hospital practitioner (OR = 1.68[1.40–2.03]) or another specialist (OR = 1.60[1.19–2.17]). The coprescription of psychotropic drugs decreased with older age in men (OR = 0.77[0.70–0.85]) and increased with older age in women (OR = 1.14[1.07–1.22]). Switches and combinations of antidepressants were not associated with age. Conclusion In a universal health care system, with similar reimbursement of drugs regardless of age, treatment duration, and adherence were better in the older patients than in the younger ones. Copyright © 2014 John Wiley & Sons, Ltd.