Dataset Information

Exploring potential explanations for the increase in antidepressant prescribing in Scotland using secondary analyses of routine data.

ABSTRACT:

Background

Antidepressant prescribing in general practice has dramatically increased since the beginning of the last decade.

Aim

To determine if the increase in antidepressants prescribed in Scotland between 1995 and 2001 was due to increase in incidence, prevalence, care-seeking behaviour by patients, or identification by GPs of depression.

Method

Secondary analysis of routine data. Prescribing information was obtained from Information and Statistics Division Scotland, psychosocial morbidity from the Scottish Health Surveys of 1995 and 1998 and GP consultations from the continuous morbidity recording (CMR) dataset. Annual trends in antidepressant prescribing for prescriptions, gross ingredient cost and defined daily doses (DDDs) were examined for all Scottish Practices and 54 stable CMR practices (175 955 patients). Prevalence of psychological morbidity in responders with a General Health Questionnaire score > or = 4, their contact probability and contact frequency was compared in the 1995 and 1998 Scottish Health Surveys. Changes in diagnostic and GP consultation patterns in CMR practices were compared.

Results

Total prescriptions for antidepressants increased from 1.5 million in 1995-1996 to 2.8. million in 2000-2001. The gross ingredient cost increased from pounds 20 to pounds 44 million and total DDDs from 44.5 to 93.2 million. Prescription trends in CMR practices were similar. Overall prevalence of psychological morbidity was the same in the 1995 and 1998 Scottish Health Surveys. Percentage of consultations in CMR practices for new diagnoses of depression decreased from 1.7 to 1.3%, the depression-related contact rate decreased and annual prevalence rates for depressive illness were stable between 1998-1999 and 2000-2001.

Conclusions

There is no evidence of an increase in incidence, prevalence, care-seeking behaviour or identification of depression during the period of a sharp increase in antidepressant prescribing. Further work is required to explain the increase.

SUBMITTER: Munoz-Arroyo R

PROVIDER: S-EPMC1839016 | biostudies-literature | 2006 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Exploring potential explanations for the increase in antidepressant prescribing in Scotland using secondary analyses of routine data.

Munoz-Arroyo Rosalia R Sutton Matt M Morrison Jill J

The British journal of general practice : the journal of the Royal College of General Practitioners 20060601 527

<h4>Background</h4>Antidepressant prescribing in general practice has dramatically increased since the beginning of the last decade.<h4>Aim</h4>To determine if the increase in antidepressants prescribed in Scotland between 1995 and 2001 was due to increase in incidence, prevalence, care-seeking behaviour by patients, or identification by GPs of depression.<h4>Method</h4>Secondary analysis of routine data. Prescribing information was obtained from Information and Statistics Division Scotland, psy ...[more]

PMID: 16762123

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Project description:BackgroundInexpensive antihypertensive drugs are at least as effective and safe as more expensive drugs. Overuse of newer, more expensive antihypertensive drugs is a poor use of resources. The potential savings are substantial, but vary across countries, in large part due to differences in prescribing patterns. We wanted to describe prescribing patterns of antihypertensive drugs in ten countries and explore possible reasons for inter-country variation.MethodsNational prescribing profiles were determined based on information on sales and indications for prescribing. We sent a questionnaire to academics and drug regulatory agencies in Canada, France, Germany, UK, US and the Nordic countries, asking about explanations for differences in prescribing patterns in their country compared with the other countries. We also conducted telephone interviews with medical directors of drug companies in the UK and Norway, the countries with the largest differences in prescribing patterns.ResultsThere is considerable variation in prescribing patterns. In the UK thiazides account for 25% of consumption, while the corresponding figure for Norway is 6%. In Norway alpha-blocking agents account for 8% of consumption, which is more than twice the percentage found in any of the other countries. Suggested factors to explain inter-country variation included reimbursement policies, traditions, opinion leaders with conflicts of interests, domestic pharmaceutical production, and clinical practice guidelines. The medical directors also suggested hypotheses that: Norwegian physicians are early adopters of new interventions while the British are more conservative; there are many clinical trials conducted in Norway involving many general practitioners; there is higher cost-awareness among physicians in the UK, in part due to fund holding; and there are publicly funded pharmaceutical advisors in the UK.ConclusionTwo compelling explanations the variation in prescribing that warrant further investigation are the promotion of less-expensive drugs by pharmaceutical advisors in UK and the promotion of more expensive drugs through "seeding trials" in Norway.

Dataset Information

Exploring potential explanations for the increase in antidepressant prescribing in Scotland using secondary analyses of routine data.

Background

Aim

Method

Results

Conclusions

Publications

Exploring potential explanations for the increase in antidepressant prescribing in Scotland using secondary analyses of routine data.

Similar Datasets

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