Luca Degli Esposti1, Carlo Piccinni2, Diego Sangiorgi3, Andrea Fagiolini4, Stefano Buda3. 1. CliCon Srl, Health, Economics and Outcomes Research, Via Salara, 36, 48100, Ravenna, Italy. luca.degliesposti@clicon.it. 2. Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. 3. CliCon Srl, Health, Economics and Outcomes Research, Via Salara, 36, 48100, Ravenna, Italy. 4. Department of Molecular Medicine, University of Siena, Siena, Italy.
Abstract
AIM: This study aimed to describe the prescription pattern of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) in an Italian setting, focusing on therapy duration, switching and adherence. METHOD: Historic cohort study, based on administrative databases of three Italian local health-units, was conducted. Patients with a prescription of antidepressants (ADs) in 2009 were enrolled and grouped into: (1) naïve, (2) already in treatment with the same drug and (3) already in treatment with a different drug. Therapy duration, switching and adherence [as medication possession ratio-(MPR)] were evaluated. A logistic regression model was performed to identify predictors of adherence. RESULTS: There were 88,755 subjects recruited: 37 % naïve, 58 % already in treatment with the same drug and 4 % with different drug. A treatment duration of ≤3 months was found in 41 % of naïve patients, whereas the majority of patients already in treatment had a duration of ≥6 months. Switches occurred in 0.7 % of the whole cohort and mostly occurred between two different SSRIs. The 63 % of naïve patients had a low adherence (MPR < 60 %), whereas a good adherence (MPR ≥ 80 %) was found in 58 % of patients already in treatment with the same drug and in 39 % of those already in treatment with different drug. Predictors of adherence were: female gender, increasing comorbidity and pain absence. All ADs, except for fluoxetine and venlafaxine, showed a better adherence than paroxetine. CONCLUSION: Notwithstanding the difficulty to associate the AD prescription to the specific diagnosis of depression, this study highlighted a short duration and a low adherence of AD therapies, especially at the initiation of treatment. Physicians should carefully balance the need to prescribe these drugs, considering the great likelihood of a short duration of treatment and a very low level of adherence.
AIM: This study aimed to describe the prescription pattern of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) in an Italian setting, focusing on therapy duration, switching and adherence. METHOD: Historic cohort study, based on administrative databases of three Italian local health-units, was conducted. Patients with a prescription of antidepressants (ADs) in 2009 were enrolled and grouped into: (1) naïve, (2) already in treatment with the same drug and (3) already in treatment with a different drug. Therapy duration, switching and adherence [as medication possession ratio-(MPR)] were evaluated. A logistic regression model was performed to identify predictors of adherence. RESULTS: There were 88,755 subjects recruited: 37 % naïve, 58 % already in treatment with the same drug and 4 % with different drug. A treatment duration of ≤3 months was found in 41 % of naïve patients, whereas the majority of patients already in treatment had a duration of ≥6 months. Switches occurred in 0.7 % of the whole cohort and mostly occurred between two different SSRIs. The 63 % of naïve patients had a low adherence (MPR < 60 %), whereas a good adherence (MPR ≥ 80 %) was found in 58 % of patients already in treatment with the same drug and in 39 % of those already in treatment with different drug. Predictors of adherence were: female gender, increasing comorbidity and pain absence. All ADs, except for fluoxetine and venlafaxine, showed a better adherence than paroxetine. CONCLUSION: Notwithstanding the difficulty to associate the AD prescription to the specific diagnosis of depression, this study highlighted a short duration and a low adherence of AD therapies, especially at the initiation of treatment. Physicians should carefully balance the need to prescribe these drugs, considering the great likelihood of a short duration of treatment and a very low level of adherence.
Authors: Anna Fernández; Alejandra Pinto-Meza; Juan Angel Bellón; Pere Roura-Poch; Josep M Haro; Jaume Autonell; Diego José Palao; María Teresa Peñarrubia; Rita Fernández; Elena Blanco; Juan Vicente Luciano; Antoni Serrano-Blanco Journal: Gen Hosp Psychiatry Date: 2010-01-12 Impact factor: 3.238
Authors: Helga Gardarsdottir; Antoine C G Egberts; Liset van Dijk; Miriam C J M Sturkenboom; Eibert R Heerdink Journal: Pharmacoepidemiol Drug Saf Date: 2009-01 Impact factor: 2.890
Authors: Brandon Lippold; Yash R Tarkunde; Abby L Cheng; Charles P Hannon; Muyibat A Adelani; Ryan P Calfee Journal: Arthroplast Today Date: 2022-03-02
Authors: Mirjam Hempenius; Rolf H H Groenwold; Anthonius de Boer; Olaf H Klungel; Helga Gardarsdottir Journal: Pharmacoepidemiol Drug Saf Date: 2021-09-07 Impact factor: 2.732