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Duration and adherence of antidepressant treatment (2003 to 2007) based on prescription database*

Published online by Cambridge University Press:  16 April 2020

M.C. Serna ,
I. Cruz ,
J. Real ,
E. Gascó  and
L. Galván
M.C. Serna
Affiliation:
University of Lleida, Lleida, Spain Regional Primary Care Management Office, Catalan Institute of Health, Lleida, Spain
I. Cruz
Affiliation:
Primary Care Research Institute, IDIAP Jordi Gol, Catalan Institute of Health, Lleida, Spain Ronda Health Center, Catalan Institute of Health, Lleida, Spain
J. Real*
Affiliation:
University of Lleida, Lleida, Spain Primary Care Research Institute, IDIAP Jordi Gol, Catalan Institute of Health, Lleida, Spain
E. Gascó
Affiliation:
Ronda Health Center, Catalan Institute of Health, Lleida, Spain
L. Galván
Affiliation:
Catalan Health Department, Lleida, Spain
*
*Corresponding author. Unitat de Suport a la Recerca. Àmbit Atenció Primària Lleida, IDIAP Jordi Gol–ICS, Lleida, Spain. Tel.: +0034-973 728293. E-mail address: [email protected] (J. Real).
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Abstract

Background

Many patients discontinue antidepressant therapy long before the six-month minimum duration recommended for the treatment of major depression and many other diagnoses.

Purpose

To estimate the duration of antidepressant treatment and to analyse the following factors in relation to treatment adherence: age, sex, polypharmacy and type of drug.

Methods

Retrospective cohort followed up for five years (2003–2007) based on prescription database. Selection criteria: Users who had received at least one antidepressant prescription in 2003 and who had not received antidepressants during the previous 12 months.

Variables studied

Age, sex, drug, polypharmacy, period of treatment, packs dispensed. Adequate adherence was defined as dispensation of medication during at least 80% of the treatment period, and compliance was defined as good when, in addition, the treatment lasted more than four months.

Results

Of the 7525 patients selected, 56% abandoned medication during the first four months. Men were more likely to give up medication before time than women. Good compliance was recorded in 22% of patients and was twice as frequent in patients with high levels of polypharmacy than in those with low levels (31% vs. 15.3%). Patients receiving maprotiline, venlafaxine, mirtazapine, citalopram, clomipramine and fluoxetine presented the highest percentages of good compliance.

Conclusions

Only one out of five patients complied with treatment for over four months. Treatment periods were shorter in men. In chronic processes, patients receiving polypharmacy presented the best compliance.

Keywords

AntidepressantDrug utilization reviewMedication adherencePrescribingPrimary careTreatment
Type
Original article
Information
European Psychiatry , Volume 25 , Issue 4 , May 2010 , pp. 206 - 213
Copyright
Copyright © Elsevier Masson SAS 2010

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Footnotes

1

These authors contributed equally to this work.

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