Lalji Hasnain M, McGrogan Anita, Bailey Sarah J
Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY, UK.
J Affect Disord Rep. 2021 Dec;6:100205. doi: 10.1016/j.jadr.2021.100205. Epub 2021 Aug 4.
Background Growing concerns about the impact of coronavirus disease 2019 (COVID-19) will likely lead to increased mental health diagnoses and treatment. To provide a pre-COVID-19 baseline, we have examined antidepressant prescribing trends for 5 years preceding COVID-19. Methods A retrospective analysis of anonymised data on medicines prescribed by GPs in England from the Open-Prescribing Database (January 2015 to December 2019) identified the 10 most prescribed antidepressant and, for comparison, cardiovascular medicines. Results Prescription items for the 10 most prescribed antidepressants rose 25% from 58 million (2015) to 72 million (2019). Citalopram was the most prescribed antidepressant; prescriptions for sertraline rose fastest at 2 million items year on year. Over the same period, costs for antidepressant prescribing fell 27.8%. Across all Clinical Commissioning Groups (CCGs) in England, antidepressant prescribing levels, adjusted for population were positively correlated with the index of multiple deprivation (IMD) score. In comparison, prescribing for the top 10 most prescribed cardiovascular medicines increased by 2.75% from 207 million (2015) to 213 million (2019) items. Limitations Anonymised data in the Open-Prescribing Database means no patient diagnoses or treatment plans are linked to this data. Conclusion Antidepressant prescribing, particularly sertraline, is increasing. Prescribing is higher in more deprived regions, but costs are falling to < 2% of all items prescribed. Absolute numbers of prescriptions for cardiovascular medicines are higher, likely reflecting the greater prevalence of cardiovascular disease, and are rising more slowly. This study will enable future work to look at the impact of COVID-19 on prescribing for mental health.
背景 对2019冠状病毒病（COVID-19）影响的日益担忧可能会导致心理健康诊断和治疗的增加。为了提供COVID-19之前的基线数据，我们研究了COVID-19之前5年的抗抑郁药处方趋势。方法 对来自开放处方数据库（2015年1月至2019年12月）的英格兰全科医生开具的药品匿名数据进行回顾性分析，确定了10种最常用的抗抑郁药，并与心血管药物进行比较。结果 10种最常用抗抑郁药的处方量从2015年的5800万（份）增至2019年的7200万（份），增长了25%。西酞普兰是最常用的抗抑郁药；舍曲林的处方量增长最快，每年增加200万份。同期，抗抑郁药处方费用下降了27.8%。在英格兰所有临床委托小组（CCG）中，经人口调整后的抗抑郁药处方水平与多重剥夺指数（IMD）得分呈正相关。相比之下，10种最常用心血管药物的处方量从2015年的2.07亿（份）增至2019年的2.13亿（份），增长了2.75%。局限性 开放处方数据库中的匿名数据意味着没有患者诊断或治疗计划与这些数据相关联。结论 抗抑郁药的处方量，尤其是舍曲林，正在增加。在贫困程度较高的地区处方量更高，但费用降至所有处方项目的不到2%。心血管药物的处方绝对数量更高，这可能反映了心血管疾病的更高患病率，且增长更为缓慢。这项研究将有助于未来研究COVID-19对心理健康处方的影响。
