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Trends in patterns of antidepressant use in older general population between 2006 and 2012 following publication of practice guidelines
Author(s) -
Etchepare Fanny,
Pambrun Elodie,
Verdoux Hélène,
Tournier Marie
Publication year - 2017
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.4536
Subject(s) - medicine , medical prescription , logistic regression , population , antidepressant , cohort , specialty , anxiety , residence , psychiatry , family medicine , emergency medicine , gerontology , demography , environmental health , pharmacology , sociology
Objective The French regulatory agency published in 2006 practice guidelines related to the management of depressive and anxiety disorders. The main objective of the study was to assess their impact regarding use and monitoring of antidepressant drug treatment in older patients. The secondary objective was to identify factors associated with compliance with practice guidelines. Methods A historical fixed cohort study with dynamic follow‐up time was conducted in 16,144 subjects aged 65 years and over, initiating antidepressant treatment and registered in the National Health Insurance Database between 2006 and 2012. Compliance with guidelines was assessed from year to year using segmented regression analysis. Multiple logistic regressions were used to identify factors associated with compliance with guidelines. Results Duration of antidepressant treatment was compliant with guidelines in 13.0% of patients aged 65–74 years and 18.5% of patients aged 75 years and over. Biological monitoring was performed in 12.6% of patients aged 65–74 years and 18.5% of patients aged 75 years and over. No significant change of rate of compliance with guidelines was observed over the study period. Compliance of prescriptions with guidelines was associated with patient's age, specialty of the prescriber, presence of chronic disease, year of treatment initiation, and presence of a university hospital in the area of residence. Conclusion While treatment duration and biological monitoring were often inadequate in older patients, the publication of guidelines by the French health regulatory authorities did not lead to any significant and sustained improvement in their patterns of antidepressant use. Copyright © 2016 John Wiley & Sons, Ltd.