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Most antidepressant use in primary care is justified; results of the Netherlands Study of Depression and Anxiety.

Piek E, van der Meer K, Hoogendijk WJ, Penninx BW, Nolen WA - PLoS ONE (2011)

Bottom Line: After recalculating these numbers to the original population (n = 10,677), we found 908 (95% CI 823 to 994) antidepressant users.We found that overtreatment with antidepressants in primary care is not a frequent problem.Too long continuation of treatment seems to explain the largest proportion of overtreatment as opposed to inappropriate initiation of treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

ABSTRACT

Background: Depression is a common illness, often treated in primary care. Many studies have reported undertreatment with antidepressants in primary care. Recently, some studies also reported overtreatment with antidepressants. The present study was designed to assess whether treatment with antidepressants in primary care is in accordance with current guidelines, with a special focus on overtreatment.

Methodology: We used baseline data of primary care respondents from the Netherlands Study of Depression and Anxiety (NESDA) (n = 1610). Seventy-nine patients with treatment in secondary care were excluded. We assessed justification for treatment with antidepressant according to the Dutch primary care guidelines for depression and for anxiety disorders. Use of antidepressants was based on drug-container inspection or, if unavailable, on self-report. Results were recalculated to the original population of primary care patients from which the participants in NESDA were selected (n = 10,677).

Principal findings: Of 1531 included primary care patients, 199 (13%) used an antidepressant, of whom 188 (94.5%) (possibly) justified. After recalculating these numbers to the original population (n = 10,677), we found 908 (95% CI 823 to 994) antidepressant users. Forty-nine (95% CI 20 to 78) of them (5.4%) had no current justification for an antidepressant, but 27 of them (54.5%) had a justified reason for an antidepressant at some earlier point in their life.

Conclusions: We found that overtreatment with antidepressants in primary care is not a frequent problem. Too long continuation of treatment seems to explain the largest proportion of overtreatment as opposed to inappropriate initiation of treatment.

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Related in: MedlinePlus

Recruitment flow respondents.
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pone-0014784-g001: Recruitment flow respondents.

Mentions: Descriptive statistics and frequencies were used to describe the use of AD and psychological treatment. We recalculated the found numbers and percentages of justified and unjustified treatment with antidepressants in our sample to the original population of 10,677 persons who returned a completed K-10 plus screener questionnaire. This backward projection was done in several steps, which can be derived by reading Figure 1 from the bottom up, or from table 1.


Most antidepressant use in primary care is justified; results of the Netherlands Study of Depression and Anxiety.

Piek E, van der Meer K, Hoogendijk WJ, Penninx BW, Nolen WA - PLoS ONE (2011)

Recruitment flow respondents.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3066192&req=5

pone-0014784-g001: Recruitment flow respondents.
Mentions: Descriptive statistics and frequencies were used to describe the use of AD and psychological treatment. We recalculated the found numbers and percentages of justified and unjustified treatment with antidepressants in our sample to the original population of 10,677 persons who returned a completed K-10 plus screener questionnaire. This backward projection was done in several steps, which can be derived by reading Figure 1 from the bottom up, or from table 1.

Bottom Line: After recalculating these numbers to the original population (n = 10,677), we found 908 (95% CI 823 to 994) antidepressant users.We found that overtreatment with antidepressants in primary care is not a frequent problem.Too long continuation of treatment seems to explain the largest proportion of overtreatment as opposed to inappropriate initiation of treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

ABSTRACT

Background: Depression is a common illness, often treated in primary care. Many studies have reported undertreatment with antidepressants in primary care. Recently, some studies also reported overtreatment with antidepressants. The present study was designed to assess whether treatment with antidepressants in primary care is in accordance with current guidelines, with a special focus on overtreatment.

Methodology: We used baseline data of primary care respondents from the Netherlands Study of Depression and Anxiety (NESDA) (n = 1610). Seventy-nine patients with treatment in secondary care were excluded. We assessed justification for treatment with antidepressant according to the Dutch primary care guidelines for depression and for anxiety disorders. Use of antidepressants was based on drug-container inspection or, if unavailable, on self-report. Results were recalculated to the original population of primary care patients from which the participants in NESDA were selected (n = 10,677).

Principal findings: Of 1531 included primary care patients, 199 (13%) used an antidepressant, of whom 188 (94.5%) (possibly) justified. After recalculating these numbers to the original population (n = 10,677), we found 908 (95% CI 823 to 994) antidepressant users. Forty-nine (95% CI 20 to 78) of them (5.4%) had no current justification for an antidepressant, but 27 of them (54.5%) had a justified reason for an antidepressant at some earlier point in their life.

Conclusions: We found that overtreatment with antidepressants in primary care is not a frequent problem. Too long continuation of treatment seems to explain the largest proportion of overtreatment as opposed to inappropriate initiation of treatment.

Show MeSH
Related in: MedlinePlus