A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care |
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Authors: | Gianluca Trifirò Silvia Tillati Edoardo Spina Carmen Ferrajolo Marianna Alacqua Eugenio Aguglia Laura Rizzi Achille P. Caputi Claudio Cricelli Fabio Samani |
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Affiliation: | 1. Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Via Consolare Valeria Gazzi, 98125, Messina, Italy 2. Department of Economic and Statistical Sciences, University of Udine, Udine, Italy 3. Pharmacovigilance and Pharmacoepidemiology Regional Center, Department of Experimental Medicine, Pharmacology Section, Second University of Naples, Naples, Italy 4. Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy 5. Italian College of General Practitioners, Florence, Italy 6. Local Health Unit of Trieste, Trieste, Italy
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Abstract: | Purpose Our purpose was to explore antidepressant drug (AD) prescribing patterns in Italian primary care. Methods Overall, 276 Italian general practitioners (GPs) participated in this prospective study, recruiting patients >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’ 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. Results 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. Conclusions 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. |
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