Article
Co-medication in patients with antidepressant therapy under real life conditions – analysis of a German claims database
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Published: | November 12, 2007 |
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Context: Co-medication under antidepressant therapy may indicate concomitant disease(s). Though clarity can hardly be gained from RCTs, usually favouring monotherapy. Claims data of sickness funds, however, are unbiased from study designs and allow insight in daily treatment practice.
Aim of the study: To retrospectively evaluate co-medication of patients with antidepressant therapy; to draw a picture of the spectrum of underlying diseases.
Material und methods: Billing data of a German sickness fund with 4.7 million life years insured were used for 2001 to 2003. Beneficiaries were included, if they were covered at least three months by the health insurance and had either an inpatient or sick leave diagnosis of depression (ICD 10: F32, F33) or/and at least two antidepressant prescriptions (ATC: N06A*). Characteristic prescription patterns were described, co-medication was analyzed.
Results: Out of 1.54 million beneficiaries n=75,078 fulfilled the inclusion criteria (mean age: 48±15 years; 57% female). The diagnosis of depression could be found in n=33,508 (2.2%) beneficiaries. For n=16,789 (50.1%) of them at least one prescription of an antidepressant could be detected during the three-year observation period. 73.4% of the treated patients received at least one TCA, 40.9% a SSRI, and 7.5% a SNRI. The most frequently administered co-medication were opioids, benzodiazepine receptor agonists, and vitamin B compounds, the latter being a possible indicator for neuropathic pain.
Conclusions: The study confirms that prescription prevalence of antidepressants for patients with depression is generally low. Beneficiaries who had exclusively been selected based on antidepressant prescriptions showed higher rates of opioid co-medication (29.1% of patients) than beneficiaries with depression diagnosis (21.4%). This may be due to the fact that those patients suffer from a different set of primary diseases.