Abbing-Karahagopian V, Huerta C, Souverein P C, de Abajo F, Leufkens H G M, Slattery J, Alvarez Y, Miret M, Gil M, Oliva B, Hesse U, Requena G, de Vries F, Rottenkolber M, Schmiedl S, Reynolds R, Schlienger R G, de Groot M C H, Klungel O H, van Staa T P, van Dijk L, Egberts A C G, Gardarsdottir H, De Bruin M L
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, P.O. Box 80 082, Utrecht, The Netherlands.
Eur J Clin Pharmacol. 2014 Jul;70(7):849-57. doi: 10.1007/s00228-014-1676-z. Epub 2014 May 3.
Drug utilization studies have applied different methods to various data types to describe medication use, which hampers comparisons across populations. The aim of this study was to describe the time trends in antidepressant prescribing in the last decade and the variation in the prevalence, calculated in a uniform manner, in seven European electronic healthcare databases.
Annual prevalence per 10,000 person-years (PYs) was calculated for 2001-2009 in databases from Spain, Germany, Denmark, the United Kingdom (UK), and the Netherlands. Prevalence data were stratified according to age, sex, antidepressant type (selective serotonin re-uptake inhibitors [SSRIs] or tricyclic antidepressants [TCAs]) and major indications.
The age- and sex-standardized prevalence was lowest in the two Dutch (391 and 429 users per 10,000 PYs) and highest in the two UK (913 and 936 users per 10,000 PYs) populations in 2008. The prevalence in the Danish, German, and Spanish populations was 637, 618, and 644 users per 10,000 PY respectively. Antidepressants were prescribed most often in 20- to 60-year-olds in the two UK populations compared with the others. SSRIs were prescribed more often than TCAs in all except the German population. In the majority of countries we observed an increasing trend of antidepressant prescribing over time. Two different methods identifying recorded indications yielded different ranges of proportions of patients recorded with the specific indication (15-57% and 39-69% for depression respectively).
Despite applying uniform methods, variations in the prevalence of antidepressant prescribing were obvious in the different populations. Database characteristics and clinical factors may both explain these variations.
药物利用研究已将不同方法应用于各种数据类型来描述药物使用情况，这妨碍了不同人群之间的比较。本研究的目的是描述过去十年中抗抑郁药处方的时间趋势，以及在七个欧洲电子医疗数据库中以统一方式计算的患病率变化。
计算了2001年至2009年西班牙、德国、丹麦、英国和荷兰数据库中每10000人年的年患病率。患病率数据根据年龄、性别、抗抑郁药类型（选择性5-羟色胺再摄取抑制剂[SSRIs]或三环类抗抑郁药[TCAs]）和主要适应症进行分层。
2008年，荷兰的两个人群中年龄和性别标准化患病率最低（每10000人年分别为391和429使用者），英国的两个人群中最高（每10000人年分别为913和936使用者）。丹麦、德国和西班牙人群中的患病率分别为每10000人年637、618和644使用者。与其他人群相比，英国的两个人群中20至60岁的人群抗抑郁药处方最为频繁。除德国人群外，所有国家中SSRIs的处方频率均高于TCAs。在大多数国家，我们观察到抗抑郁药处方随时间呈上升趋势。两种识别记录适应症的不同方法得出了记录有特定适应症患者比例的不同范围（抑郁症分别为15 - 57%和39 - 69%）。
尽管采用了统一方法，但不同人群中抗抑郁药处方患病率的差异仍然明显。数据库特征和临床因素可能都能解释这些差异。
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