Faculty of Health and Medicines Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur J Clin Pharmacol. 2013 May;69(5):1167-71. doi: 10.1007/s00228-012-1447-7. Epub 2012 Nov 6.
To investigate whether general practitioners, hospital physicians and specialized practitioners in psychiatry have similar preferences for initiating treatment with expensive serotonin-specific reuptake inhibitors (SSRIs).
All first-time prescriptions for the SSRIs escitalopram, citalopram and sertraline reported to the Danish National Register of Medicinal Product Statistics from April 1, 2009 until March 31, 2010 were analysed with regard to treatment naivety and type of prescriber. A prescription was considered as first time if the patient had not received a prescription for the same drug within the last 2 years. Patients who had not received a prescription for an antidepressant within 6 months prior to the date of redemption were classified as treatment-naïve.
We included 82,702 first-time prescriptions, 65,313 (79 %) of which were for treatment-naïve patients. Of the treatment-naïve patients, 19 % were initially prescribed escitalopram. Hospital physicians prescribed escitalopram to 34 % of their treatment-naïve patients, while practitioners specialized in psychiatry prescribed it to 25 %, and general practitioners prescribed it to 17 %. General practitioners, however, were responsible for initiating 87 % of all treatment-naïve patients.
The most expensive SSRI, escitalopram, is prescribed as first choice to one in five patients receiving their first antidepressant of escitalopram, citalopram or sertraline. General practitioners made the bulk of all first-time SSRI prescriptions to treatment-naïve patients.
调查初级保健医生、医院医生和精神科专科医生在开始使用昂贵的选择性 5-羟色胺再摄取抑制剂（SSRIs）治疗方面是否具有相似的偏好。
从 2009 年 4 月 1 日至 2010 年 3 月 31 日，对向丹麦国家药品统计数据库报告的所有首次开具的 SSRIs（艾司西酞普兰、西酞普兰和舍曲林）处方进行分析，主要分析指标为治疗初治情况和开具处方的医生类型。如果患者在过去 2 年内未接受同一药物的处方，则认为该处方为首次处方。在开始报销日期前 6 个月内未接受抗抑郁药处方的患者被归类为初治患者。
我们共纳入 82702 例首次处方，其中 65313 例（79%）为初治患者。在初治患者中，19%的患者最初开具了艾司西酞普兰。医院医生为 34%的初治患者开具了艾司西酞普兰，而专门从事精神科的医生开具了 25%，全科医生开具了 17%。然而，全科医生负责启动所有初治患者的 87%。
最昂贵的 SSRIs 艾司西酞普兰是开具给首次接受艾司西酞普兰、西酞普兰或舍曲林治疗的五分之一患者的首选药物。全科医生开出了所有初治患者中首次使用 SSRIs 的大部分处方。
