Wemakor Anthony, Casson Karen, Dolk Helen
School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana; Centre for Maternal, Foetal and Infant Research, Institute of Nursing and Health Research, University of Ulster, Jordanstown, United Kingdom.
Centre for Maternal, Foetal and Infant Research, Institute of Nursing and Health Research, University of Ulster, Jordanstown, United Kingdom.
J Affect Disord. 2014;167:299-305. doi: 10.1016/j.jad.2014.06.015. Epub 2014 Jun 19.
There has been a steady increase in the prescription of antidepressants in developed countries in recent decades. Antidepressant treatment prevalence and sociodemographic pattern data can inform the review of clinical guidelines for depression treatment. We determined the one-year prevalence and sociodemographic pattern of antidepressant dispensing among women of childbearing age (15-45 years) in Northern Ireland (NI).
A cross-sectional study using individual electronic prescribing data for 2009. Our study population was 268,917 women of childbearing age (15-45 years), with/without prescriptions, registered with the 246 out of 363GP practices in NI with high electronic prescribing data coverage. Socioeconomic deprivation (in quintiles) was measured by an area indicator attached to residential postcode.
The one-year prevalence of redeemed antidepressant prescriptions was 16.3% (95% CI 16.1-16.4). More than two-thirds of antidepressant prescriptions were for SSRIs. Thirty-five per cent of the women who redeemed prescriptions for antidepressants also redeemed prescriptions for psycholeptics within 2 months of the antidepressant prescriptions. Redeemed antidepressant prescription prevalence increased from 4.8% (15-19 years) to 24.6% (40-45 years), from 13.5% (quintile 1, least deprived) to 20.7% (quintile 5, most deprived), and with urbanity of GP practice location.
Only GP practices with high capture of electronic prescribing data were included, which may not be entirely representative of NI. We could not assess the appropriateness of prescribing according to national guidelines.
Antidepressant use is high among women of childbearing age in NI and increases with age and socioeconomic deprivation. This reinforces the need to address the determinants of depression, and assess the appropriateness of treatment policies and practices.
近几十年来，发达国家抗抑郁药的处方量一直在稳步增加。抗抑郁药治疗的患病率和社会人口学模式数据可为抑郁症治疗临床指南的审查提供参考。我们确定了北爱尔兰（NI）育龄妇女（15 - 45岁）中抗抑郁药配药的一年患病率及社会人口学模式。
采用2009年个人电子处方数据进行横断面研究。我们的研究人群为268,917名育龄妇女（15 - 45岁），她们在NI的363家全科医生诊所中有246家注册，这些诊所电子处方数据覆盖率高，无论是否有处方。社会经济剥夺程度（分为五等份）通过附在居住邮政编码上的区域指标来衡量。
已兑现的抗抑郁药处方的一年患病率为16.3%（95%可信区间16.1 - 16.4）。超过三分之二的抗抑郁药处方是用于选择性5-羟色胺再摄取抑制剂（SSRI）。在开具抗抑郁药处方的妇女中，35%的人在开具抗抑郁药处方后的2个月内还开具了精神药物处方。已兑现的抗抑郁药处方患病率从4.8%（15 - 19岁）增至24.6%（40 - 45岁），从13.5%（第1等份，最不贫困）增至20.7%（第5等份，最贫困），且随全科医生诊所所在地的城市化程度而增加。
仅纳入了电子处方数据捕获率高的全科医生诊所，这可能无法完全代表NI。我们无法根据国家指南评估处方的适当性。
NI育龄妇女中抗抑郁药的使用很普遍，且随年龄和社会经济剥夺程度增加。这进一步强调了需要解决抑郁症的决定因素，并评估治疗政策和做法的适当性。
