Antidepressants utilization among elderly in Lombardy from 2000 to 2007: Dispensing trends and appropriateness

Alberto Parabiaghi, Carlotta Franchi, Mauro Tettamanti, Angelo Barbato, Barbara D'Avanzo, Ida Fortino, Angela Bortolotti, Luca Merlino, Alessandro Nobili

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the prevalence and incidence of antidepressant (AD) use in the elderly during an 8-year period and to evaluate AD treatment appropriateness. Methods: A population-based dispensation study on community-dwelling elderly of a large area in Lombardy was performed. Data were drawn from the regional administrative database and from a general practice registry. For each year, prevalence of AD use (i.e., at least one recorded dispensation) and AD treatment (i.e., at least four recorded dispensations) was compared. Results: The prevalence of AD use and treatment doubled and tripled, respectively. The greatest shift occurred between 2000 and 2002 and was entirely due to SSRIs. The most pronounced increase was seen in females who accounted for 72% of all dispensations. The increase in prevalence was not mirrored by incident use, which slightly decreased (OR: 0.98; 95% CI: 0.98-0.98). The proportion of those who received a minimally adequate AD treatment grew over the years (OR: 1.63; 95% CI: 1.59-1.68). The increase in prevalence of AD treatment was most pronounced among older age groups (ORs between 1.02 and 1.06 for age classes ≥75 years relative to the 65-69 age class; P lt; 0.001) and was proportional to that of depressive disorders. Conclusions: A dramatic rise in dispensations was observed. The increasing prevalence of minimally adequately treated subjects and a possible decrease in untreated depression may reflect an improvement in the pharmacological treatment of depression. The increase in prevalence and not in the incidence of dispensations could be related to an inappropriate prolongation of treatment duration.

Original languageEnglish
Pages (from-to)1077-1083
Number of pages7
JournalEuropean Journal of Clinical Pharmacology
Volume67
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Antidepressant
  • Appropriateness
  • Dispensation database
  • Elderly
  • Utilization

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

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