[Study of use of psychiatric drugs in primary care]

Abstract

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.