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A framework for describing the impact of antidepressant medications on population health status
Author(s) -
Patten Scott B.
Publication year - 2002
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.746
Subject(s) - medicine , antidepressant , population , depression (economics) , public health , mental health , psychiatry , population health , environmental health , gerontology , anxiety , nursing , economics , macroeconomics
Background In the absence of strategies for primary prevention, public health initiatives for major depression have generally focused on secondary and tertiary strategies such as case‐finding, public and professional education and disease management. Much emphasis has been placed on low reported rates of antidepressant utilization. In principle, increased rates of treatment utilization should lead to improved mental health status at the population level. However, methods for relating antidepressant utilization to population health status have not been described. Methods An incidence–prevalence model was developed using data from a Canadian national survey, supplemented by parameter estimates from literature reviews. The lifetime sick‐day proportion (LSP) was used to approximate point prevalence. Results Mathematical simulations using this model produced reasonable approximations of point prevalence for major depression. The model suggests that an improved rate of treatment utilization may not, in itself, lead to substantially reduced prevalence. Reducing the rate of relapse in those with highly recurrent disorders, which can be accomplished by long‐term antidepressant treatment, is predicted to have a more substantial impact on population health status. Conclusions The model presented here offers a framework for describing the impact of antidepressant treatment on population health status. Mathematical models may assist with decision‐making and priority setting in the public health sphere, as illustrated by the model presented here, which challenges some commonly held assumptions. Copyright © 2002 John Wiley & Sons, Ltd.