OBJECTIVES: While the prescription of SSRIs and SNRIs for
major depressive disorder (MDD) has increased, resource utilisation
has rarely been studied in large populations in real-life settings.
The purpose of this study was to assess resource utilisation
associated with the prescription of antidepressants in an adult
population with MDD in primary care using data extracted
from the General Practitioner Research Database (GPRD).
METHODS: We conducted a retrospective study using the
GPRD. Patients diagnosed with MDD aged 18-70 having a new
prescription of paroxetine, fluoxetine, citalopram, sertraline, escitalopram,
venlafaxine or amitriptyline between January 1, 2001
and September 30, 2003 and not having received antidepressant
treatment in the previous six-months were included. Analyses
focused on first depressive episodes for each patient. Patient,
disease and treatment characteristics, GP visits, referrals and hospitalisations
were analysed. RESULTS: Information was gathered
from over 59,000 patients. Mean age of patients was 39
and 69% were female. 57% suffered from mild depression, 37%
moderate and 6% severe. Mean time of a depressive episode was
about 6 months. Patients visited a GP on average 10 times per
episode. There was a trend between frequency of GP visits and
severity per episode (10 for mild, 11 for moderate and 12 for
severe). 2% of patients were referred to psychiatric specialists.
Compared with patients under SSRIs, there were 80% more
referrals under SNRIs and 20% fewer under TCAs. 4% of all
patients were hospitalized: 60% more hospitalisations under
SNRIs and 40% more under TCAs compared with SSRIs. CONCLUSIONS:
This GPRD-based study provides better knowledge
of medical resource use in depressed patients in the UK. It should
promote better prescription strategies and use of antidepressants
in primary care.