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Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees

OBJECTIVES: We examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees. METHODS: The study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region...

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Detalles Bibliográficos
Autores principales: Jensen, Johan Høy, Bonde, Jens Peter, Flachs, Esben Meulengracht, Skakon, Janne, Rod, Naja Hulvej, Kawachi, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581106/
https://www.ncbi.nlm.nih.gov/pubmed/30617127
http://dx.doi.org/10.1136/oemed-2018-105442
Descripción
Sumario:OBJECTIVES: We examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees. METHODS: The study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region of Denmark. Multilevel mixed-effects parametric survival models were developed to examine time to prescription for psychotropic medications (anxiolytics/hypnotics/sedatives/antidepressants) during the 12-month interval following exposure to organisational changes relative to no change from January to December 2013. Data on work-unit level organisational changes (including mergers, split-ups, relocation, change in management, employee lay-offs and budget cuts) were collected from work-unit managers (59% response). RESULTS: Any organisational change versus no change was associated with a higher risk of psychotropic prescription (HR: 1.14, 95% CI: 1.02 to 1.26), especially change in management (HR: 1.23, 95% CI: 1.07 to 1.41). Splitting the 12-month follow-up period into two halves yielded particularly high rates of psychotropic prescription in the latter half of the follow-up, for example, any change (HR: 1.25, 95% CI: 1.11 to 1.41), change in management (HR: 1.42, 95% CI: 1.22 to 1.65), mergers (HR: 1.26, 95% CI: 1.06 to 1.50), employee lay-off (HR: 1.23, 95% CI: 1.03 to 1.46) and budget cuts (HR: 1.13, 95% CI: 1.00 to 1.41). The associations did not vary by sex. CONCLUSIONS: Organisational changes in the workplace, especially change in management, may be associated with increased risk of psychotropic prescription among employees regardless of sex.