[Study of use of psychiatric drugs in primary care]. / Estudio de utilización de psicofármacos en atención primaria.

OBJECTIVE: To get to know the profile of use of antidepressants (AD) and tranquilizers-hypnotics (T-H) in primary care in Catalonia. DESIGN: Transversal, observational, epidemiological study of prescription-indication. LOCATION: Health centres in Catalonia, Spain. PARTICIPANTS: Included, using consecutive sampling, patients on treatment with AD and/or T-H. MEASUREMENTS: The variables studied were: age, sex, type and number of drugs, treatment schemes, reason for prescribing, and the health professional who initiated it. RESULTS: 1613 drugs were evaluated: 43% were AD and 57% were T-H. The sub-groups most prescribed were: selective serotonin reuptake inhibitors (SSRI) (31.6%) and short half-life (32.9%) and long half-life (19.8%) benzodiazepines (BZD). We included 998 patients, 76% of the participants were women. The average age was 52.24 years (range, 16-96). 19.9% (n=199) received treatment with AD only, 34.3% (n=342) with T-H only, and 45.8% (n=457) combined treatment. The mean number of drugs per patient was 1.6. The main reasons for prescribing were: major depression or dysthymia (60.2%; n=417) for AD and generalised anxiety (33.3%; n=306) and insomnia (23.9%; n=220) for T-H. 39.8% (n=268) of the AD and 51.0% (n=441) of T-H had been prescribed for more than 1 year. CONCLUSION: The described profile of the use of psychiatric drugs suggests the need to reconsider the over-prescribing of BDZ and improve coordination between psychiatrists and primary care doctors.

Estudio de utilización de psicofármacos en atención primaria / Study of use of psychiatric drugs in primary care

Objetivo. Conocer el perfil de utilización de antidepresivos (AD) y ansiolíticos/hipnóticos (A/H) en atención primaria (AP) en Cataluña. Diseño. Estudio epidemiológico, observacional, transversal de prescripción-indicación. Emplazamiento. Centros de salud de Cataluña. Participantes. Se incluyó, mediante muestreo consecutivo, a pacientes en tratamiento con AD y/o A/H. Mediciones. Las variables estudiadas fueron: edad, sexo, tipo y número de fármacos, pautas de tratamiento, motivo de la prescripción y profesional que la inició. Resultados. Se evaluaron 1.613 fármacos: el 43% fue AD y el 57% A/H. Los subgrupos más prescritos fueron: inhibidores selectivos de la recaptación de serotonina (ISRS) (31,6%), y benzodiacepinas (BZD) de vida media corta (32,9%) y larga (19,8%). Se incluyeron 998 pacientes. El 76% de los participanetes eran mujeres. La edad media era de 52,24 años (rango, 16-96). El 19,9% (n = 199) de los pacientes recibía sólo tratamiento con AD; el 34,3% (n = 342), sólo con A/H, y el 45,8% (n = 457), tratamiento combinado. La media de fármacos por paciente fue de 1,6 ± 0,91. Los motivos principales de prescripción fueron: depresión mayor o distimia (60,2%; n = 417) para los AD y ansiedad generalizada (33,3%; n = 306) e insomnio (23,9%; n = 220) para los A/H. El 39,8% (n = 268) de los AD y el 51,0% (n = 441) de los A/H se habían prescrito hacía más de 1 año. Conclusión. El perfil de utilización de psicofármacos descrito nos plantea la necesidad de reconducir la hiperprescripción de BZD y mejorar la coordinación entre psiquiatras y médicos de AP

Objective. To get to know the profile of use of antidepressants (AD) and tranquilizers-hypnotics (T-H) in primary care in Catalonia. Design. Transversal, observational, epidemiological study of prescription-indication. Location. Health centres in Catalonia, Spain. Participants. Included, using consecutive sampling, patients on treatment with AD and/or T-H. Measurements. The variables studied were: age, sex, type and number of drugs, treatment schemes, reason for prescribing, and the health professional who initiated it. Results. 1613 drugs were evaluated: 43% were AD and 57% were T-H. The sub-groups most prescribed were: selective serotonin reuptake inhibitors (SSRI) (31.6%) and short half-life (32.9%) and long half-life (19.8%) benzodiazepines (BZD). We included 998 patients, 76% of the participants were women. The average age was 52.24 years (range, 16-96). 19.9% (n=199) received treatment with AD only, 34.3% (n=342) with T-H only, and 45.8% (n=457) combined treatment. The mean number of drugs per patient was 1.6. The main reasons for prescribing were: major depression or dysthymia (60.2%; n=417) for AD and generalised anxiety (33.3%; n=306) and insomnia (23.9%; n=220) for T-H. 39.8% (n=268) of the AD and 51.0% (n=441) of T-H had been prescribed for more than 1 year. Conclusion. The described profile of the use of psychiatric drugs suggests the need to reconsider the over-prescribing of BDZ and improve coordination between psychiatrists and primary care doctors