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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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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 |
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author | Jensen, Johan Høy Bonde, Jens Peter Flachs, Esben Meulengracht Skakon, Janne Rod, Naja Hulvej Kawachi, Ichiro |
author_facet | Jensen, Johan Høy Bonde, Jens Peter Flachs, Esben Meulengracht Skakon, Janne Rod, Naja Hulvej Kawachi, Ichiro |
author_sort | Jensen, Johan Høy |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6581106 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65811062019-07-05 Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees Jensen, Johan Høy Bonde, Jens Peter Flachs, Esben Meulengracht Skakon, Janne Rod, Naja Hulvej Kawachi, Ichiro Occup Environ Med Workplace 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. BMJ Publishing Group 2019-03 2019-01-07 /pmc/articles/PMC6581106/ /pubmed/30617127 http://dx.doi.org/10.1136/oemed-2018-105442 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Workplace Jensen, Johan Høy Bonde, Jens Peter Flachs, Esben Meulengracht Skakon, Janne Rod, Naja Hulvej Kawachi, Ichiro Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title | Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title_full | Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title_fullStr | Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title_full_unstemmed | Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title_short | Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
title_sort | work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees |
topic | Workplace |
url | 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 |
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