A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care

作者：Trifiro Gianluca^*; Tillati Silvia; Spina Edoardo; Ferrajolo Carmen; Alacqua Marianna; Aguglia Eugenio; Rizzi Laura; Caputi Achille P; Cricelli Claudio; Samani Fabio

来源：European Journal of Clinical Pharmacology, 2013, 69(2): 227-236.

DOI：10.1007/s00228-012-1319-1

• General practice
• Antidepressives
• Pharmacoepidemiology
• Italy

Our purpose was to explore antidepressant drug (AD) prescribing patterns in Italian primary care. %26lt;br%26gt;Overall, 276 Italian general practitioners (GPs) participated in this prospective study, recruiting patients %26gt; 18 years who started AD therapy during the enrolment period (January 2007 to June 2008). During visits at baseline and 3, 6, and 12 months, data about patients%26apos; characteristics and AD treatments were collected by the GPs. Discontinuation rate among new users of AD classes [i.e., selective serotonin reuptake inhibitors (SSRI); tricyclics (TCAs); other ADs) were compared. Logistic regression analyses were performed to identify predictors of AD discontinuation. %26lt;br%26gt;SSRIs were the most frequently prescribed ADs (N = 1,037; 75.3 %), especially paroxetine and escitalopram. SSRIs were more likely to be prescribed because of depressive disorders (80 %), and by GPs (51.1 %) rather than psychiatrists (31.8 %). Overall, 27.5 % (N = 378) of AD users discontinued therapy during the first year, mostly in the first 3 months (N = 242; 17.6 %), whereas 185 (13.4 %) were lost to follow-up. SSRI users showed the highest discontinuation rate (29 %). In patients with depressive disorders, younger age, psychiatrist-based diagnosis, and treatment started by GPs were independent predictors of SSRI discontinuation. %26lt;br%26gt;In Italy, ADs-especially SSRIs-are widely prescribed by GPs because of depressive/anxiety disorders. Active monitoring of AD users in general practice might reduce the AD discontinuation rate.

• 出版日期2013-2