Serna M Catalina, Real Jordi, Cruz Inés, Galván Leonardo, Martin Elisabet
Universidad de Lleida- IRB-Lleida, Lleida, Spain.
Centre d'Atenció Primària Eixample, Institut Català de la Salut, Lleida, Spain.
BMC Public Health. 2015 Nov 26;15:1184. doi: 10.1186/s12889-015-2493-8.
Clinical practice guidelines consider the use of antidepressants as one of the standard treatments for anxiety disorders, due to the significant improvements obtained in quality of life and functional disability. In addition, in patients who have not achieved a favorable response after 3 months of psychotherapy, antidepressants are recommended as part of a combined treatment approach. This combination with psychotropic drugs and psychotherapy appears to be indicated from baseline in patients with moderate, severe or recurrent depression. In the last decade, antidepressant prescription rates in general practice have increased between 4 and 10 times. Depression presents high rates of relapse and recurrence. Treatment is often interrupted prematurely, leading to increases in both relapse rates and health care costs. Few studies have analysed the chronic use of antidepressant drugs and long-term adherence.
To evaluate compliance with antidepressant treatment between 2003 and 2011 and to explore the associated factors.
Retrospective cohort study of antidepressant dispensing.
Health Region of Lleida between 2003 and 2011.
Patients with chronic prescription of antidepressants (ATC code NO6A) during 2003 were followed up until December 2011. The sample comprised 3684 subjects.
The compliance rate was calculated on the basis of the number of units withdrawn from the pharmacy and the theoretical number of units required according to the scheduled duration of treatment: compliance was defined in cases with scores greater than or equal to 80%.
12.5% of patients received chronic antidepressant treatment for at least 4 years. Mean age was 54 years, and 73.2% of patients were female. Almost a third (32.4%) presented anxiety disorders and 26.5% mood disorders. The overall compliance rate was 22% (28% in patients with depression, and 21% in patients with anxiety). According to gender, compliance rates were 21.4% for males and 22.4% for females. Compliance was more likely in patients with polypharmacy.
One in 4 patients complied with treatment. Factors associated with better compliance were polypharmacy and diagnosis of depressive or mixed anxiety-depressive disorder.
临床实践指南将使用抗抑郁药视为焦虑症的标准治疗方法之一，因为在生活质量和功能残疾方面取得了显著改善。此外，对于经过3个月心理治疗后未取得良好疗效的患者，建议将抗抑郁药作为联合治疗方法的一部分。对于中度、重度或复发性抑郁症患者，从基线开始就似乎适合将这种精神药物与心理治疗相结合。在过去十年中，全科医疗中的抗抑郁药处方率增加了4至10倍。抑郁症的复发率和再发率很高。治疗常常过早中断，导致复发率和医疗保健成本增加。很少有研究分析抗抑郁药的长期使用和长期依从性。
评估2003年至2011年期间抗抑郁药治疗的依从性，并探讨相关因素。
对抗抑郁药配药进行回顾性队列研究。
2003年至2011年期间莱里达健康区。
2003年期间有抗抑郁药（ATC代码NO6A）长期处方的患者随访至2011年12月。样本包括3684名受试者。
依从率根据从药房取出的药品数量和根据预定治疗时长所需的理论药品数量计算得出：得分大于或等于80%的情况定义为依从。
12.5%的患者接受了至少4年的抗抑郁药长期治疗。平均年龄为54岁，73.2%的患者为女性。近三分之一（32.4%）的患者患有焦虑症，26.5%的患者患有情绪障碍。总体依从率为22%（抑郁症患者为28%，焦虑症患者为21%）。按性别划分，男性依从率为21.4%，女性依从率为22.4%。联合用药的患者更有可能依从。
四分之一的患者依从治疗。依从性较好的相关因素是联合用药以及诊断为抑郁或混合性焦虑抑郁障碍。
