Sicras-Mainar Antoni, Navarro-Artieda Ruth
Research Unit, Badalona Serveis Assistencials SA, Badalona, Barcelona, Spain.
Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Neuropsychiatr Dis Treat. 2015 Dec 30;12:29-40. doi: 10.2147/NDT.S91227. eCollection 2016.
To describe antidepressant (AD) use in the treatment of major depressive disorder during a period of economic crisis.
This was a retrospective, observational study using population-based databases. Two periods were considered: 1) 2008-2009, precrisis, and 2) 2012-2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment). Patients were followed up for 12 months. The main measures were use (defined daily doses), epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.
In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8%) discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.
Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs.
描述在经济危机期间抗抑郁药（AD）用于治疗重度抑郁症的情况。
这是一项使用基于人群的数据库的回顾性观察研究。研究考虑了两个时期：1）2008 - 2009年，危机前；2）2012 - 2013年，经济危机期间。研究纳入/排除标准（AD治疗起始）被纳入考量。对患者进行了12个月的随访。主要测量指标包括使用情况（限定日剂量）、流行病学指标、使用的策略、治疗持续性、转诊情况以及资源利用情况。设定统计学显著性水平为P<0.05。
危机前时期纳入3662例患者，经济危机期间纳入5722例患者。平均年龄分别为58.8岁和65.4%为女性。比较两个时期，重度抑郁症患病率分别为5.4%和8.1%，P<0.001。在经济危机期间，AD的使用量增加了35.2%，药物支出减少了38.7%。每位患者每天的限定日剂量分别为10.0毫克和13.5毫克，P<0.001。在12个月的随访中，大多数患者（60.8%）停止治疗或继续使用之前相同的药物，23.3%的患者更换了AD药物。
初级卫生保健专业人员高度参与该疾病的管理；此外，在经济危机期间，重度抑郁症患者的患病率更高，AD药物的使用增加。
