1
|
Moreno HF, Almeida ACGOD. [Prescription of antidepressants in primary care: a descriptive study on medical professionals' confidence]. CAD SAUDE PUBLICA 2024; 40:e00130323. [PMID: 39194096 DOI: 10.1590/0102-311xpt130323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/23/2024] [Indexed: 08/29/2024] Open
Abstract
Antidepressants are the third most prescribed drug class, and most prescriptions are not performed by specialists. This study aimed to evaluate primary health care (PHC) physicians' self-perceived confidence in prescribing antidepressants. This is a cross-sectional study with PHC physicians in the municipality of Salvador, Bahia State, Brazil. Psychiatrists or psychiatry residents were excluded. The self-assessment of confidence and the collection of participants' characteristics was carried out by an online questionnaire. Categorical variables were presented in absolute and relative frequencies. Continuous variables were described as means or medians according to their normality distribution. Of 447 physicians, the sample consisted of 55 participants. Their mean age was 37.2 ± 12.8 years. Most physicians (75%) claimed confidence in prescribing antidepressants. Self-perceived confidence remained predominant in scenarios with older adults (69.2%) and patients with general comorbidities (65.4%). A minority showed confidence to prescribe antidepressants to children/adolescents (19.2%) and pregnant women (26.9%). For 80.4% of participants, selective serotonin reuptake inhibitors were the most trusted pharmacological class. Referral to the Psychosocial Care Center was the most reported strategy in cases of insecure prescription (32%). To the best of our knowledge, this is the first study to address such an issue. Thus, it can contribute to more assertive health education actions for PHC physicians.
Collapse
|
2
|
Redican E, McDowell R, Rosato M, Murphy J, Leavey G. Patterns of antidepressant prescribing and health-related outcomes among older adults in Northern Ireland: an administrative data study. Aging Ment Health 2024:1-8. [PMID: 39113568 DOI: 10.1080/13607863.2024.2387667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/28/2024] [Indexed: 08/18/2024]
Abstract
OBJECTIVES This study identifies patterns of antidepressant prescribing and subsequent hospital admissions from 2010 to 2018 amongst older adults in Northern Ireland (NI). METHOD Participants comprised all General Practitioner (GP)-registered adults aged fifty-five years and above on 01/01/2010 (n = 386,119). Administrative data linkage included demographic information; antidepressant prescribing data from the NI Enhanced Prescribing Database (EPD); and hospital patient admissions. Repeated measures latent class analysis (RMLCA) identified patterns of antidepressant prescribing (from 2010 to 2018). RESULTS RMLCA identified four latent classes: decreasing antidepressant prescribing (5.9%); increasing antidepressant prescribing (8.0%); no-antidepressant prescribing (68.7%); and long-term antidepressant prescribing (17.5%). Compared with those in no-antidepressant prescribing class, persons in the remaining classes were more likely to be female and younger, and less likely to live in either rural areas or less-deprived areas. Compared with no-antidepressant prescribing, those with increasing antidepressant prescribing were 60% and 52% more likely to be admitted to hospital in 2019 and 2020, respectively, and their admission rate per year was 11% and 8% higher in 2019 and 2020, respectively. Similarly, those with long-term prescriptions were 70% and 67% more likely to be admitted to hospital in 2019 and 2020, respectively, and their admission rate per year was 14% and 9% higher in 2019 and 2020, respectively. CONCLUSION Findings show that approximately 26% of the NI hospital admissions population were impacted by sustained or increasing antidepressant prescribing. Because of their increased likelihood of hospitalization, these individuals may benefit from psychosocial support and social prescribing alternatives to psychopharmacological treatment.
Collapse
Affiliation(s)
- Enya Redican
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Ulster University, Coleraine, UK
| | - Ronald McDowell
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Ulster University, Coleraine, UK
| | - Michael Rosato
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Ulster University, Coleraine, UK
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Jamie Murphy
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Ulster University, Coleraine, UK
| | - Gerard Leavey
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Ulster University, Coleraine, UK
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| |
Collapse
|
3
|
Van Leeuwen E, Maund E, Woods C, Bowers H, Christiaens T, Kendrick T. Health care professional barriers and facilitators to discontinuing antidepressant use: A systematic review and thematic synthesis. J Affect Disord 2024; 356:616-627. [PMID: 38640978 DOI: 10.1016/j.jad.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Long-term antidepressant (AD) use, much longer than recommended, is very common and can lead to potential harms. OBJECTIVE To investigate the existing literature on perspectives of health professionals (HPs) regarding long-term AD treatment, focusing on barriers and facilitators to discontinuation. METHODS A systematic review with thematic synthesis. Eight electronic databases were searched until August 2023 including MEDLINE, PubMed, Embase, PsycINFO, CINAHL, AMED, Health Management Information Consortium, and the Networked Digital Library of Theses and Dissertation. RESULTS Thirteen studies were included in the review. Of these, nine focused on general practitioner perspectives, one on psychiatrist perspectives, and three on a mix of HPs perspectives. Barriers and facilitators to discontinuing long-term ADs emerged within eight themes, ordered chronologically based on HP considerations during an AD review: perception of AD use, fears, HP role and responsibility, HPs' perception of AD discontinuation, HPs' confidence regarding their ability to manage discontinuation, perceived patient readiness to stop, support from patient's trusted people, and support from other HPs. LIMITATIONS Coding and development of subthemes and themes was performed by one researcher and further developed through discussion within the research team. CONCLUSION Deprescribing long-term ADs is a challenging concept for HPs. The review found evidence that the barriers far outweigh the facilitators with fear of relapse as a main barrier. HP education, reassurance and confidence-building is essential to increase the initiation of the discontinuation process. Further research into the perspectives of pharmacists and mental health workers is needed as well as exploring the role of trusted people.
Collapse
Affiliation(s)
- Ellen Van Leeuwen
- Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent University, Belgium; Department of Public Health and Primary Care, Ghent University, Belgium.
| | - Emma Maund
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Catherine Woods
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Hannah Bowers
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| | - Thierry Christiaens
- Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent University, Belgium
| | - Tony Kendrick
- Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, University of Southampton, Southampton, United Kingdom
| |
Collapse
|
4
|
Geremie T, Guiguet-Auclair C, Laroche ML, Mely P, Gerbaud L, Blanquet M. Deprescribing in older adults in a French community: a questionnaire study on patients' beliefs and attitudes. BMC Geriatr 2024; 24:562. [PMID: 38937665 PMCID: PMC11212408 DOI: 10.1186/s12877-024-05165-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND General practitioners (GPs) have a central role to play on reduction of polypharmacy and deprescribing. This study aimed to assess beliefs and attitudes towards deprescribing in patients, aged 65 years or older in primary care, and to identify factors associated with deprescribing and their willingness to stop medication. METHODS A questionnaire study was performed between 23 May and 29 July 2022 on patients aged 65 years or older attending a GP's surgery in a French area. We used the French version of the revised Patients' Attitudes Towards Deprescribing self-report questionnaire (rPATD), which measures four subscales ("Burden", "Appropriateness", "Concerns about stopping" and, "Involvement"), patients' willingness to stop one of their regular medicines, and patients' satisfaction with their current medicines. RESULTS The study enrolled 200 patients. Median age was 76 years old (IQR 71-81), 55% were women, and 42.5% took 5 or more medications per day. Although most patients (92.5%) were satisfied with their current medicines, 35% were reluctant to stop medications they had been taking for a long time, and 89.5% were willing to stop medication if asked to by their GP. Patients aged less than 75 years old reported more concerns about stopping. Women and patients with higher educational attainment showed significantly higher involvement in medication management. CONCLUSIONS The majority of older adults were willing to stop one or more of their regular medicines if asked to do so by their GP. GPs should address deprescribing into their current practice.
Collapse
Affiliation(s)
| | - Candy Guiguet-Auclair
- Public Health, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
- Clermont Auvergne INP, Clermont Auvergne College, University Hospital of Clermont-Ferrand, CNRS Pascal Institute, Clermont-Ferrand, France
| | - Marie Laure Laroche
- Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology- Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, Limoges, France
- UR 24134 (Ageing, Frailty, Prevention, e-Health), Institute Omega Health, University of Limoges, Limoges, France
| | - Pierre Mely
- Surgery of Riom-ès-Montagnes, Riom-ès-Montagnes, France
| | - Laurent Gerbaud
- Public Health, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
- Clermont Auvergne INP, Clermont Auvergne College, University Hospital of Clermont-Ferrand, CNRS Pascal Institute, Clermont-Ferrand, France
| | - Marie Blanquet
- Public Health, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
- Clermont Auvergne INP, Clermont Auvergne College, University Hospital of Clermont-Ferrand, CNRS Pascal Institute, Clermont-Ferrand, France.
| |
Collapse
|
5
|
Romagnoli A, Zovi A, Santoleri F, Lasala R. Antidepressant deprescribing: State of the art and recommendations-A literature overview. Eur J Clin Pharmacol 2024; 80:417-433. [PMID: 38189859 DOI: 10.1007/s00228-023-03617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION In recent years, the consumption of antidepressants has arisen. However, deprescribing antidepressant therapy is very complicated. The aim of this study was to implement practical recommendations for the development of guidelines to be used for antidepressant deprescription in clinical practice. MATERIALS AND METHODS The literature search has been conducted on March 13, 2023, using Scopus and PubMed databases. The following search string has been used: "antidepressants AND (deprescribing OR deprescription)". All studies reporting a deprescribing intervention for antidepressant medication, regardless of the study design, have been included. Studies that did not report antidepressant drug deprescription interventions and non-English-language papers have been excluded. RESULTS From the literature search, a total of 230 articles have been extracted. Applying the exclusion criteria, 26 articles have been considered eligible. Most of the analyzed studies (16, 61%) have been carried out in the real world, 3 (11%) were RCTs, 5 (19%) were qualitative studies, in particular expert opinions, 1 (4%) was a literature review, and 1 (4%) was a post-trial observational follow-up of an RCT. In 8 out of 26 studies (31%), the analyzed antidepressants have been specified: 2 (8%) focused on anticholinergics, 2 (8%) on SSRIs, 3 (11%) on tricyclic antidepressants, and 1 (4%) on esketamine. Nineteen out of 26 studies (73%) did not stratify antidepressants by therapeutic class. The sample sizes analyzed in the studies ranged from a minimum of 4 patients to a maximum of 113,909, and 12 studies included geriatric age as an inclusion criterion. A patient's therapy review has been the main deprescribing intervention, and it has been identified in 14 (54%) articles. Interventions have been carried out by clinicians in 4 (15%) studies, general practitioners in 5 (19%) studies, nurses in 2 (8%) studies, pharmacists in 4 (15%) studies, multidisciplinary teams in 10 (38%) studies, and patients in 1 (4%) study. CONCLUSIONS From the literature review, it emerged that there is no clear evidence useful to support clinicians in antidepressant deprescribing interventions.
Collapse
Affiliation(s)
- Alessia Romagnoli
- Territorial Pharmaceutical Service, Local Health Unit Lanciano Vasto Chieti, Chieti, Italy.
| | - Andrea Zovi
- Ministry of Health, Viale Giorgio Ribotta 5, 00144, Rome, Italy
| | | | - Ruggero Lasala
- Hospital Pharmacy of Corato, Local Health Unit of Bari, Corato, Italy
| |
Collapse
|
6
|
Coutts-Bain D, Sharpe L, Techakesari P, Forrester MA, Hunt C. A mixed-methods review and meta-synthesis of fears of recurrence and progression in people with mental health conditions. Clin Psychol Rev 2023; 105:102342. [PMID: 37804564 DOI: 10.1016/j.cpr.2023.102342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/23/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023]
Abstract
A fear that one's physical illness will recur or worsen has received substantial research attention over the past decade, most notably as fear of cancer recurrence. Indeed, such fear is known to be associated with poorer quality of life, adjustment, and psychopathology. However, fear of a recurrence or progression (FORP) of mental health conditions has received comparatively little study. The present review aimed to, 1) systematically review quantitative research on FORP in mental health regarding its association with age, gender, quality of life, mental health outcomes, and health behaviours, and 2) meta-synthesize qualitative research related to FORP to construct a transdiagnostic model. A qualitative meta-synthesis of 19 studies identified four subthemes underlying FORP (fear of symptoms, loss of progress, fear of death, and traumatic experiences). The three themes related to FORP were: inability to trust oneself, hypervigilance, and a low-risk low-reward lifestyle which was comprised of three subthemes (limiting relationships, limiting life goals, and fear of changing treatment). A quantitative systematic review of 15 studies found that FORP was strongly associated with worse quality of life, and greater depression, anxiety, psychotic symptoms, and medication adherence, but was not associated with age or gender. Hence, FORP can be understood transdiagnostically, and is generally associated with poorer mental health outcomes but may also predict adaptive health behaviours, such as appropriate medication adherence.
Collapse
Affiliation(s)
- Daelin Coutts-Bain
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Australia.
| | - Pirathat Techakesari
- School of Psychology, Faculty of Science, The University of Sydney, Australia; Cancer Centre for Children, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Australia; Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Australia
| | | | - Caroline Hunt
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| |
Collapse
|
7
|
Hølmkjær P, Vermehren C, Holm A, Rozing MP, Høj K, Overbeck G. Tailoring a complex intervention to reduce antidepressants in institutionalized older persons with dementia. BMC Health Serv Res 2022; 22:1582. [PMID: 36572903 PMCID: PMC9791154 DOI: 10.1186/s12913-022-08961-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/12/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION First-line treatment for behavioral and psychiatric symptoms of dementia is non-pharmacological. Still, psychotropic medication is widely used, despite its limited effect and harmful side-effects. More than half of all nursing home residents with dementia receive antidepressants, even though deprescribing is safe and feasible. Interventions to promote deprescribing of antidepressants in nursing homes are few and complex. To optimize the deprescribing process through an intervention, transparency for the development of the intervention is needed. We aim to describe the steps in the development and tailoring of an intervention targeting GPs, nursing home staff, and relatives to enhance collaboration on reducing the use of antidepressants in institutionalized older persons with dementia in Denmark. METHOD A step-wise process guided by the core elements in the Medical Research Council constituted the tailoring process. Five steps were included; 1) a literature search, 2) interviews with stakeholders, 3) drafting the intervention prototype, 4) professionals' assessment of the intervention, and 5) refinement of the intervention. The steps were conducted from June 2020 to June 2022. RESULTS Based on the literature search, interviews with stakeholders, and professionals' assessment of the intervention, four main themes were identified; 1) focusing on antidepressants, 2) importance of professional qualifications, 3) collaboration and communication, and 4) patient and relative involvement. They guided intervention development and refinement of the final intervention, which included 1) a case-based training course and 2) a dialog tool including a symptom assessment scale to be used in a structured consultation at the nursing home. CONCLUSION This study presents a detailed account of the tailoring process for a complex intervention to optimize deprescribing of antidepressants for older persons with dementia at nursing homes. By presenting a thorough development process, we expect to achieve increased adherence to the intervention which is currently being tested in an ongoing cluster randomized controlled trial. The transparency of the process will also increase the future development of other similar complex interventions.
Collapse
Affiliation(s)
- Pernille Hølmkjær
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Section of General Practice and Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Vermehren
- grid.4973.90000 0004 0646 7373Department of Clinical Pharmacology, University Hospital Copenhagen, Capital Region, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Holm
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Section of General Practice and Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Maarten Pieter Rozing
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Section of General Practice and Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Kirsten Høj
- grid.7048.b0000 0001 1956 2722Research Unit for General Practice, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark ,grid.27530.330000 0004 0646 7349Unit of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
| | - Gritt Overbeck
- grid.5254.60000 0001 0674 042XDepartment of Public Health, Section of General Practice and Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
Heinrich CH, McHugh S, McCarthy S, Donovan MD. Barriers and enablers to deprescribing in long-term care: A qualitative investigation into the opinions of healthcare professionals in Ireland. PLoS One 2022; 17:e0274552. [PMID: 36520798 PMCID: PMC9754218 DOI: 10.1371/journal.pone.0274552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/31/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The prevalence of polypharmacy increases with age, increasing the exposure of older adults to potentially inappropriate medications (PIMs). Deprescribing has been shown to reduce PIMs for older residents in long-term care; however, deprescribing is not universally implemented. This study aims to identify the barriers and enablers to deprescribing in Irish long-term care facilities from the healthcare professionals' (HCPs) perspective. METHODS A qualitative descriptive approach was conducted using semi-structured interviews with HCPs working in long-term care (general practitioners, pharmacists and nurses). Purposive sampling with maximum variation was applied to select long-term care sites to identify HCPs, supplemented with convenience sampling of post-graduate HCPs from University College Cork. Data was thematically analysed and mapped to a framework of deprescribing barriers and enablers informed by the Theoretical Domains Framework. RESULTS Twenty-six HCPs participated from 13 long-term care facilities. The main barriers and enablers identified mapped to five domains. Barriers included insufficient resources, lack of co-ordination between healthcare settings and negative social influences. Additional barriers exist in private settings including deprescribing awareness, commitment and the need for incentives. Deprescribing enablers included interprofessional support and patient social influence. To encourage deprescribing, potential enablers include HCP education, pharmacist role expansion and tailored deprescribing guidelines within a structured process. CONCLUSION Interventions to support deprescribing should build on existing systems, involve stakeholders and utilise guidelines within a structured process. Any intervention must account for the nuanced barriers and enablers which exist in both public and private settings.
Collapse
Affiliation(s)
- Clara H. Heinrich
- School of Pharmacy, University College Cork, Cork City, Co. Cork, Ireland
- * E-mail:
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork City, Co. Cork, Ireland
| | - Suzanne McCarthy
- School of Pharmacy, University College Cork, Cork City, Co. Cork, Ireland
| | - Maria D. Donovan
- School of Pharmacy, University College Cork, Cork City, Co. Cork, Ireland
| |
Collapse
|
9
|
McCool A, Lukas K, Hayes P, Kelly D. Antidepressant medication prescribing patterns in Irish general practice from 2016 to 2020 to assess for long-term use. Ir J Med Sci 2022; 191:2239-2246. [PMID: 34714490 PMCID: PMC8554180 DOI: 10.1007/s11845-021-02833-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to identify the trends in antidepressant (AD) medication use in two Irish general practices over a 5-year period, 2016 to 2020. The rationale for this study is attributed to the growing prevalence of depression amongst the Irish general public as well as concerns surrounding long-term AD medication use. METHODS The research was undertaken in 2021 examining AD prescription rates from 2016 to 2020. The medications of interest were selective serotonin and norepinephrine reuptake inhibitors (SSRI and SNRIs): sertraline, escitalopram, fluoxetine and venlafaxine. The number of medical card holders (MCH) and prescription dispensing rates were analysed for observable trends. RESULTS AD medication use is rising amongst the Irish MCH population. The number of MCH prescribed AD grew from 9.42 to 12.3 per 100 MCH between the years 2016 and 2020, respectively. The year 2020 represented the largest proportion of MCH prescriptions, 6.32 AD prescriptions per 1000 MCH prescriptions. The years 2019 to 2020 represented the largest annual increase in prescription dispensing with a growth of 0.45 per 1000 MCH prescriptions. Annual figures show a continual increase in AD dispensing refill rates from 4.14 to 5.67 per 1000 MCH prescriptions in 2016 and 2020, respectively. CONCLUSION This study illustrates a steady rise in AD medication within the general practice setting, with an observed rise in prescription dispensing rates. The high proportion of refill prescriptions demonstrates the long-term use of AD medications. This may be indicative of chronic depression or may highlight a lack of appropriate medication cessation strategies.
Collapse
Affiliation(s)
- Aoibhin McCool
- University of Limerick School of Medicine, Limerick, Ireland.
| | - Kurt Lukas
- University of Limerick School of Medicine, Limerick, Ireland
| | - Peter Hayes
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Dervla Kelly
- Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
10
|
Amaral CMM, Carvalho RC, Vieira MEB, Aguiar PM. Factors Associated With Use of Medications for Anxiety and Depression in Pharmacy Students in Brazil. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8285. [PMID: 34315701 PMCID: PMC8341240 DOI: 10.5688/ajpe8285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 02/23/2021] [Indexed: 06/13/2023]
Abstract
Objective. To map undergraduate pharmacy students' use of medications for anxiety and depression and associated factors at one university in Brazil.Methods. A cross-sectional study was conducted from May to July 2019 among undergraduate pharmacy students at one university. Data regarding sociodemographic issues and the use of psychotropics were collected using an online questionnaire. Exploratory descriptive analysis of data, the chi-square test, and multivariate binary logistic regression were performed to identify factors associated with the use of medications for anxiety and depression.Results. Of 900 students enrolled, usable survey responses were received from 198. Most respondents were female with a mean age of 22.3 years. Among these, 17.7% of pharmacy students used medications to treat anxiety and 13.1% used medications for depression. The most common psychotropics were escitalopram and fluoxetine. There were two peak usage times: the initial and final year of pharmacy school. Dissatisfaction with the pharmacy program and psychological care were significantly associated with the use of medications for anxiety. In contrast, monthly income from three to 15 times the minimum wage, religiosity/spirituality, and psychological care were associated with students' use of medications for depression.Conclusion. There was a high prevalence of medication use to treat anxiety and depression among undergraduate pharmacy students, and this use was associated with psychological care, monthly income, and religiosity/spirituality.
Collapse
Affiliation(s)
| | - Renata Cunha Carvalho
- University Hospital of University of São Paulo, Psychiatric Outpatient Clinic, São Paulo, Brazil
| | | | | |
Collapse
|