Outcomes associated with antidepressant treatment according to the number of prescriptions and treatment changes : 5-year follow-up of a nation-wide cohort study
Copyright © 2022 Ouazana-Vedrines, Lesuffleur, Cuerq, Fagot-Campagna, Rachas, Gastaldi-Ménager, Hoertel, Limosin, Lemogne and Tuppin..
Background: Naturalistic studies regarding clinical outcomes associated with antidepressant treatment duration have yielded conflicting results, possibly because they did not consider the occurrence of treatment changes. This nation-wide population-based study examined the association between the number of filled prescriptions and treatment changes and long-term psychiatric outcomes after antidepressant treatment initiation.
Methods: Based on the French national health insurance database, 842,175 adults who initiated an antidepressant treatment in 2011 were included. Cox proportional-hazard multi-adjusted regression models examined the association between the number of filled prescriptions and the occurrence of treatment changes 12 months after initiation and four outcomes during a 5-year follow-up: psychiatric hospitalizations, suicide attempts, sick leaves for a psychiatric diagnosis, new episodes of antidepressant treatment.
Results: During a mean follow-up of 4.5 years, the incidence rates of the four above-mentioned outcomes were 13.49, 2.47, 4.57, and 92.76 per 1,000 person-years, respectively. The number of filled prescriptions was associated with each outcome (adjusted HRs [95% CI] for one additional prescription ranging from 1.01 [1.00-1.02] to 1.10 [1.09-1.11]), as was the occurrence of at least one treatment change vs. none (adjusted HRs [95% CI] ranging from 1.18 [1.16-1.21] to 1.57 [1.79-1.65]). Furthermore, the adjusted HRs [95% CI] of the number of filled prescriptions were greater in patients with (vs. without) a treatment change for psychiatric hospitalizations (1.12 [1.11-1.14] vs. 1.09 [1.08-1.10], p for interaction = 0.002) and suicide attempts (1.12 [1.09-1.15] vs. 1.06 [1.04-1.08], p for interaction = 0.006).
Limitations: Lack of clinical data about the disorders warranting the prescriptions or their severity.
Conclusion: Considering treatment changes is critical when using administrative claims database to examine the long-term psychiatric outcomes of antidepressant treatments in real-life settings.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Frontiers in psychiatry - 13(2022) vom: 01., Seite 923916 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ouazana-Vedrines, Charles [VerfasserIn] |
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| Links: |
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| Themen: |
Administrative claims database |
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| Anmerkungen: |
Date Revised 28.09.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fpsyt.2022.923916 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM346762057 |
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| 100 | 1 | |a Ouazana-Vedrines, Charles |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes associated with antidepressant treatment according to the number of prescriptions and treatment changes |b 5-year follow-up of a nation-wide cohort study |
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| 520 | |a Copyright © 2022 Ouazana-Vedrines, Lesuffleur, Cuerq, Fagot-Campagna, Rachas, Gastaldi-Ménager, Hoertel, Limosin, Lemogne and Tuppin. | ||
| 520 | |a Background: Naturalistic studies regarding clinical outcomes associated with antidepressant treatment duration have yielded conflicting results, possibly because they did not consider the occurrence of treatment changes. This nation-wide population-based study examined the association between the number of filled prescriptions and treatment changes and long-term psychiatric outcomes after antidepressant treatment initiation | ||
| 520 | |a Methods: Based on the French national health insurance database, 842,175 adults who initiated an antidepressant treatment in 2011 were included. Cox proportional-hazard multi-adjusted regression models examined the association between the number of filled prescriptions and the occurrence of treatment changes 12 months after initiation and four outcomes during a 5-year follow-up: psychiatric hospitalizations, suicide attempts, sick leaves for a psychiatric diagnosis, new episodes of antidepressant treatment | ||
| 520 | |a Results: During a mean follow-up of 4.5 years, the incidence rates of the four above-mentioned outcomes were 13.49, 2.47, 4.57, and 92.76 per 1,000 person-years, respectively. The number of filled prescriptions was associated with each outcome (adjusted HRs [95% CI] for one additional prescription ranging from 1.01 [1.00-1.02] to 1.10 [1.09-1.11]), as was the occurrence of at least one treatment change vs. none (adjusted HRs [95% CI] ranging from 1.18 [1.16-1.21] to 1.57 [1.79-1.65]). Furthermore, the adjusted HRs [95% CI] of the number of filled prescriptions were greater in patients with (vs. without) a treatment change for psychiatric hospitalizations (1.12 [1.11-1.14] vs. 1.09 [1.08-1.10], p for interaction = 0.002) and suicide attempts (1.12 [1.09-1.15] vs. 1.06 [1.04-1.08], p for interaction = 0.006) | ||
| 520 | |a Limitations: Lack of clinical data about the disorders warranting the prescriptions or their severity | ||
| 520 | |a Conclusion: Considering treatment changes is critical when using administrative claims database to examine the long-term psychiatric outcomes of antidepressant treatments in real-life settings | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Lesuffleur, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Cuerq, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Fagot-Campagna, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Rachas, Antoine |e verfasserin |4 aut | |
| 700 | 1 | |a Gastaldi-Ménager, Chrystelle |e verfasserin |4 aut | |
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| 700 | 1 | |a Limosin, Frédéric |e verfasserin |4 aut | |
| 700 | 1 | |a Lemogne, Cédric |e verfasserin |4 aut | |
| 700 | 1 | |a Tuppin, Philippe |e verfasserin |4 aut | |
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