Most Antidepressant Use in Primary Care Is Justified; Results of the Netherlands Study of Depression and Anxiety

Ellen Piek*, Klaas van der Meer, Witte J. G. Hoogendijk, Brenda W. J. H. Penninx, Willem A. Nolen

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

23 Citaten (Scopus)
263 Downloads (Pure)

Samenvatting

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.

Originele taal-2English
Artikelnummer14784
Aantal pagina's8
TijdschriftPLoS ONE
Volume6
Nummer van het tijdschrift3
DOI's
StatusPublished - 29-mrt.-2011

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