Open AccessCohort of one million patients initiating antidepressant treatment in France: 12‐month follow‐up
Author(s) -
Fagot JeanPaul,
Cuerq Anne,
Samson Solène,
FagotCampagna Anne
Publication year - 2016
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12850
Subject(s) - medicine , medical prescription , antidepressant , cohort , population , psychiatry , antipsychotic , defined daily dose , depression (economics) , mood , reimbursement , cohort study , pediatrics , health care , schizophrenia (object oriented programming) , anxiety , environmental health , economics , pharmacology , macroeconomics , economic growth
Summary Aims Previous studies have shown that the recommended minimum 6‐month period for antidepressant treatment is actually observed for only a minority of patients. The objectives of this study were to characterise patients with newly prescribed antidepressant treatment in France and identify factors possibly associated with insufficient duration of treatment or the occurrence of certain events such as sick leave, hospitalisations and suicide attempts. Methods Data were extracted from the French health insurance database ( SNIIRAM ) and the national hospitalisation database ( PMSI ) for patients covered by the main French health insurance scheme representing 75% of the French population. Patients were included if they had a newly prescribed antidepressant in 2011, but no prior psychiatric diagnosis identified in the databases and no significant psychiatric medication (such as antipsychotic or mood stabiliser) in 2009–2010. Results A total of 998 710 patients (2% of the overall population), with a mean age of 50 years and 66% of females, initiated an antidepressant in 2011, which was prescribed by a general practitioner in 89% of cases. Five generic names, including three selective serotonin reuptake inhibitors, accounted for 75% of first prescriptions. Only one reimbursement was observed for 40% of patients. Treatment duration was less than 6 months for more than 80% of patients, more frequently for low income earners, and varied according to age, gender and region. The median time lag between first visit and antidepressant initiation was 27 days. Hospitalisation related to a psychiatric disease over the following 12 months was observed for 3% of patients. Conclusion Duration of treatment and follow‐up were both insufficient for the majority of French patients initiating antidepressant treatment in 2011, which may reflect poor quality of care for people with mood or anxiety disorders, possibly because of overdiagnosis and inappropriate drug treatment, or poor adherence and side effects, or poor follow‐up.