Trends in patterns of antidepressant use in older general population between 2006 and 2012 following publication of practice guidelines.

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Clinical Guidelines
Authored By
Etchepare F, Pambrun E, Verdoux H, Tournier M
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Psychiatry
Internal/Family Medicine
Speciality
Psychiatry
Internal/Family Medicine
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volume
32
ISSN
1099-1166
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{"article_title":"Trends in patterns of antidepressant use in older general population between 2006 and 2012 following publication of practice guidelines.","author":"Etchepare F, Pambrun E, Verdoux H, Tournier M","journal_title":"International journal of geriatric psychiatry","issn":"1099-1166","isbn":"","publication_date":"2017 Aug","volume":"32","issue":"8","first_page":"849","page_count":"","accession_number":"27357262","doi":"10.1002\/gps.4536","publisher":"John Wiley","doctype":"Journal Article","subjects":"Antidepressive Agents therapeutic use; Anxiety Disorders drug therapy; Depressive Disorder drug therapy; Guideline Adherence trends; Practice Patterns, Physicians' trends; Aged; Aged, 80 and over; Chronic Disease; Cohort Studies; Female; France; Guideline Adherence statistics & numerical data; Humans; Logistic Models; Male; Patient Compliance","interest_area":["Psychiatry"," Internal\/Family Medicine"],"abstract":"Objective: The French regulatory agency published in 2006 practice guidelines related to the management of depressive and anxiety disorders. The main objective of the study was to assess their impact regarding use and monitoring of antidepressant drug treatment in older patients. The secondary objective was to identify factors associated with compliance with practice guidelines. Methods: A historical fixed cohort study with dynamic follow-up time was conducted in 16,144 subjects aged 65 years and over, initiating antidepressant treatment and registered in the National Health Insurance Database between 2006 and 2012. Compliance with guidelines was assessed from year to year using segmented regression analysis. Multiple logistic regressions were used to identify factors associated with compliance with guidelines. Results: Duration of antidepressant treatment was compliant with guidelines in 13.0% of patients aged 65-74 years and 18.5% of patients aged 75 years and over. Biological monitoring was performed in 12.6% of patients aged 65-74 years and 18.5% of patients aged 75 years and over. No significant change of rate of compliance with guidelines was observed over the study period. Compliance of prescriptions with guidelines was associated with patient's age, specialty of the prescriber, presence of chronic disease, year of treatment initiation, and presence of a university hospital in the area of residence. Conclusion: While treatment duration and biological monitoring were often inadequate in older patients, the publication of guidelines by the French health regulatory authorities did not lead to any significant and sustained improvement in their patterns of antidepressant use. Copyright \ufffd 2016 John Wiley & Sons, Ltd. Copyright \ufffd 2016 John Wiley & Sons, Ltd.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=27357262&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Etchepare F, Pambrun E, Verdoux H, Tournier M","Journal_Info":"Publisher: John Wiley Country of Publication: England NLM ID: 8710629 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1166 (Electronic) Linking ISSN: 08856230 NLM ISO Abbreviation: Int J Geriatr Psychiatry Subsets: MEDLINE","Publication_Type":"Journal Article; Research Support, Non-U.S. Gov't","Published_Date":"2017-08-01","Source":"International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2017 Aug; Vol. 32 (8), pp. 849-859. Date of Electronic Publication: 2016 Jun 30.","Languages":"English","Electronic_ISSN":"1099-1166","MeSH_Terms":"Antidepressive Agents\/*therapeutic use , Anxiety Disorders\/*drug therapy , Depressive Disorder\/*drug therapy , Guideline Adherence\/*trends , Practice Patterns, Physicians'\/*trends, Aged ; Aged, 80 and over ; Chronic Disease ; Cohort Studies ; Female ; France ; Guideline Adherence\/statistics & numerical data ; Humans ; Logistic Models ; Male ; Patient Compliance","Subjects":"Aged, Aged, 80 and over, Chronic Disease, Cohort Studies, Female, France, Guideline Adherence statistics & numerical data, Humans, Logistic Models, Male, Patient Compliance, Antidepressive Agents therapeutic use, Anxiety Disorders drug therapy, Depressive Disorder drug therapy, Guideline Adherence trends, Practice Patterns, Physicians' trends","Title_Abbreviations":"International journal of geriatric psychiatry","Volume":"32"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"27357262","RelevancyScore":"808","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"808.3095703125"},"plink":"https:\/\/login.openathens.net\/auth\/shalina.com\/o\/81308362?ctx=sd&l=68741486-b452-410c-bbd1-57e5f29fcd40&t=https%3a%2f%2fsearch.ebscohost.com%2flogin.aspx%3fdirect%3dtrue%26site%3deds-live%26db%3dmdl%26AN%3d27357262%26custid%3Dns346513%26groupid%3Ddev%26profile%3Deds-dev%26authtype%3Dshib","upload_link":"https:\/\/login.openathens.net\/auth\/shalina.com\/o\/81308362?ctx=sd&l=68741486-b452-410c-bbd1-57e5f29fcd40&t=https%3a%2f%2fsearch.ebscohost.com%2flogin.aspx%3fdirect%3dtrue%26site%3deds-live%26db%3dmdl%26AN%3d27357262%26custid%3Dns346513%26groupid%3Ddev%26profile%3Deds-dev%26authtype%3Dshib"}
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1099-1166
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["Etchepare F, Pambrun E, Verdoux H, Tournier M","Publisher: John Wiley Country of Publication: England NLM ID: 8710629 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1166 (Electronic) Linking ISSN: 08856230 NLM ISO Abbreviation: Int J Geriatr Psychiatry Subsets: MEDLINE","Journal Article; Research Support, Non-U.S. Gov't","2017-08-01","International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2017 Aug; Vol. 32 (8), pp. 849-859. Date of Electronic Publication: 2016 Jun 30.","English","1099-1166","Antidepressive Agents\/*therapeutic use , Anxiety Disorders\/*drug therapy , Depressive Disorder\/*drug therapy , Guideline Adherence\/*trends , Practice Patterns, Physicians'\/*trends, Aged ; Aged, 80 and over ; Chronic Disease ; Cohort Studies ; Female ; France ; Guideline Adherence\/statistics & numerical data ; Humans ; Logistic Models ; Male ; Patient Compliance","Aged, Aged, 80 and over, Chronic Disease, Cohort Studies, Female, France, Guideline Adherence statistics & numerical data, Humans, Logistic Models, Male, Patient Compliance, Antidepressive Agents therapeutic use, Anxiety Disorders drug therapy, Depressive Disorder drug therapy, Guideline Adherence trends, Practice Patterns, Physicians' trends","International journal of geriatric psychiatry","32"]
Description
Objective: The French regulatory agency published in 2006 practice guidelines related to the management of depressive and anxiety disorders. The main objective of the study was to assess their impact regarding use and monitoring of antidepressant drug treatment in older patients. The secondary objective was to identify factors associated with compliance with practice guidelines.<br />Methods: A historical fixed cohort study with dynamic follow-up time was conducted in 16,144 subjects aged 65 years and over, initiating antidepressant treatment and registered in the National Health Insurance Database between 2006 and 2012. Compliance with guidelines was assessed from year to year using segmented regression analysis. Multiple logistic regressions were used to identify factors associated with compliance with guidelines.<br />Results: Duration of antidepressant treatment was compliant with guidelines in 13.0% of patients aged 65-74 years and 18.5% of patients aged 75 years and over. Biological monitoring was performed in 12.6% of patients aged 65-74 years and 18.5% of patients aged 75 years and over. No significant change of rate of compliance with guidelines was observed over the study period. Compliance of prescriptions with guidelines was associated with patient's age, specialty of the prescriber, presence of chronic disease, year of treatment initiation, and presence of a university hospital in the area of residence.<br />Conclusion: While treatment duration and biological monitoring were often inadequate in older patients, the publication of guidelines by the French health regulatory authorities did not lead to any significant and sustained improvement in their patterns of antidepressant use. Copyright © 2016 John Wiley & Sons, Ltd.<br /> (Copyright © 2016 John Wiley & Sons, Ltd.)
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