How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis
| العنوان: | How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis |
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| المؤلفون: | Ulrike Haug, Oliver Riedel, Tammo Reinders, Wiebke Schäfer |
| المصدر: | British journal of clinical pharmacology, 87(4):1778-1789 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Data Analysis, Male, medicine.medical_specialty, Mirtazapine, Citalopram, Off-label use, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Germany, Internal medicine, medicine, Insomnia, Humans, Escitalopram, Pharmacology (medical), 030212 general & internal medicine, Medical prescription, Aged, Older adults, Antidepressants, Administrative claims, Pharmacology, business.industry, Off-Label Use, Trimipramine, Antidepressive Agents, Cross-Sectional Studies, Antidepressant, Female, medicine.symptom, business, Selective Serotonin Reuptake Inhibitors, medicine.drug |
| الوصف: | AIM:To estimate the extent of off-label prescribing of antidepressants in older adults and to characterize patients with off-label vs on-label prescriptions of antidepressants using a large German health claims database. METHODS:Using data from the German Pharmacoepidemiological Research Database (GePaRD), we conducted a cross-sectional study in adults aged 65 years or older with a dispensation of an antidepressant between 1 January 2009 and 31 December 2015 after a period of 365 days without such a dispensation. We assessed the overall and annual proportion of off-label prescriptions of antidepressants by class and individual substance. RESULTS: Among 263 276 incident users of antidepressants, the proportion of off-label prescribing was 43.6% (95% CI 43.4-43.8%) with little variation between 2009 and 2015 (42.2-44.4%). The proportion of off-label use was higher in men (49%) than women (41%). While the proportion of off-label prescriptions was highest for tri- and tetracyclic antidepressants with 56.2% (amitriptyline 54.6%, maximum 65.9% for trimipramine), it amounted to 41.8% for selective serotonin reuptake inhibitors (citalopram 41.6%, maximum 46.0% for escitalopram) and was 51.2% for mirtazapine. Indicators of overall morbidity were similar in both groups, eg, pain was coded in 72% of off-label users vs 77% of on-label users (insomnia 20% vs 24%). CONCLUSION: Our study suggests a high prevalence of off-label antidepressant use among older adults in Germany, which was not restricted to certain classes of antidepressants or individual antidepressants. Given the unclear risk-benefit ratio, studies investigating the safety of off-label use among older adults for individual antidepressants are urgently needed. |
| تدمد: | 1365-2125 0306-5251 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::802b04ffc6196b7ce4d2d90f3a83e46d https://doi.org/10.1111/bcp.14564 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....802b04ffc6196b7ce4d2d90f3a83e46d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13652125 03065251 |
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