Cargando…

Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study

BACKGROUND: The WHO Comprehensive Mental Health Action Plan 2013–2030 encourages routine collection and reporting of a set of essential mental health indicators, including the availability of psychotropic medicines. The global monitoring of country-level psychotropic medicine consumption trends can...

Descripción completa

Detalles Bibliográficos
Autores principales: Brauer, Ruth, Alfageh, Basmah, Blais, Joseph E, Chan, Esther W, Chui, Celine S L, Hayes, Joseph F, Man, Kenneth K C, Lau, Wallis C Y, Yan, Vincent K C, Beykloo, Maedeh Y, Wang, Zixuan, Wei, Li, Wong, Ian C K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9766760/
https://www.ncbi.nlm.nih.gov/pubmed/34801129
http://dx.doi.org/10.1016/S2215-0366(21)00292-3
_version_ 1784853808829956096
author Brauer, Ruth
Alfageh, Basmah
Blais, Joseph E
Chan, Esther W
Chui, Celine S L
Hayes, Joseph F
Man, Kenneth K C
Lau, Wallis C Y
Yan, Vincent K C
Beykloo, Maedeh Y
Wang, Zixuan
Wei, Li
Wong, Ian C K
author_facet Brauer, Ruth
Alfageh, Basmah
Blais, Joseph E
Chan, Esther W
Chui, Celine S L
Hayes, Joseph F
Man, Kenneth K C
Lau, Wallis C Y
Yan, Vincent K C
Beykloo, Maedeh Y
Wang, Zixuan
Wei, Li
Wong, Ian C K
author_sort Brauer, Ruth
collection PubMed
description BACKGROUND: The WHO Comprehensive Mental Health Action Plan 2013–2030 encourages routine collection and reporting of a set of essential mental health indicators, including the availability of psychotropic medicines. The global monitoring of country-level psychotropic medicine consumption trends can provide information on the extent of the availability of psychotropic medicines. The primary objective of this study was to investigate global trends in psychotropic medicines consumption from 2008 to 2019 across 65 countries and regions according to country income level and geographical region. METHODS: In this longitudinal trends study, we used pharmaceutical sales data from the IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS). We analysed monthly sales data of psychotropic medicines between Jan 1, 2008, and Dec 31, 2019. Total psychotropic medicine consumption included sales of antidepressants, antipsychotics, tranquilisers, sedatives or hypnotics, and mood stabilisers. Population estimates of each country or region (eight lower-middle-income countries, 19 upper-middle-income countries, and 38 high-income countries) were based on the UN World Population Prospects 2019 report. Average annual sales trends of psychotropic medicines, expressed as defined daily dose (DDD) per 1000 inhabitants per day, were estimated using a random-effects model adjusted for income level and region. Relative changes in the annual consumption of psychotropic medicines by income, expressed as DDD per 1000 inhabitants per day, were assessed as percentage change for each medicine class. FINDINGS: Psychotropic medicine sales increased from 28·54 DDD per 1000 inhabitants per day in 2008 to 34·77 DDD per 1000 inhabitants per day in 2019, corresponding to a 4·08% (95% CI 2·96–5·21) relative average increase annually. The absolute annual increase was greater in high-income countries (3·31 DDD per 1000 inhabitants per day, 95% CI 3·01–3·61) compared with upper-middle-income countries (1·94 DDD per 1000 inhabitants per day, 1·45–2·44) and low-middle-income countries (0·88 DDD per 1000 inhabitants per day, 0·62–1·13; p<0·0001). The relative average annual increase in psychotropic medicine sales from 2008 to 2019 was greater in upper-middle-income countries (7·88%, 95% CI 6·99–8·77) than in lower-middle-income countries (2·90%, 2·40–3·39) and high-income countries (1·02%, 0·80–1·24). In 2019, the regional consumption of psychotropic medicines varied greatly, with the highest sales of all psychotropic medicine classes reported in northern America (167·54 DDD per 1000 inhabitants per day) and lowest sales reported in Asia (5·59 DDD per 1000 inhabitants per day). 17 countries had very low consumption of psychotropic medicines in 2019, including high-income countries and countries with a high prevalence of mental disorders. INTERPRETATION: The consumption of psychotropic medicines has increased over a 12-year period, and although the absolute growth rate was highest in high-income countries, the relative growth is highest in middle-income countries and especially upper-middle-income countries. Disparities in psychotropic medicine consumption of countries can only partly be explained by geographical location and income. Greater efforts are needed to increase the availability of psychotropic medicines in countries with very low consumption, which is probably due to financial or cultural reasons as well as scarcity of trained health-care professionals to prescribe psychotropic medicines. FUNDING: None.
format Online
Article
Text
id pubmed-9766760
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier Ltd.
record_format MEDLINE/PubMed
spelling pubmed-97667602022-12-21 Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study Brauer, Ruth Alfageh, Basmah Blais, Joseph E Chan, Esther W Chui, Celine S L Hayes, Joseph F Man, Kenneth K C Lau, Wallis C Y Yan, Vincent K C Beykloo, Maedeh Y Wang, Zixuan Wei, Li Wong, Ian C K Lancet Psychiatry Articles BACKGROUND: The WHO Comprehensive Mental Health Action Plan 2013–2030 encourages routine collection and reporting of a set of essential mental health indicators, including the availability of psychotropic medicines. The global monitoring of country-level psychotropic medicine consumption trends can provide information on the extent of the availability of psychotropic medicines. The primary objective of this study was to investigate global trends in psychotropic medicines consumption from 2008 to 2019 across 65 countries and regions according to country income level and geographical region. METHODS: In this longitudinal trends study, we used pharmaceutical sales data from the IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS). We analysed monthly sales data of psychotropic medicines between Jan 1, 2008, and Dec 31, 2019. Total psychotropic medicine consumption included sales of antidepressants, antipsychotics, tranquilisers, sedatives or hypnotics, and mood stabilisers. Population estimates of each country or region (eight lower-middle-income countries, 19 upper-middle-income countries, and 38 high-income countries) were based on the UN World Population Prospects 2019 report. Average annual sales trends of psychotropic medicines, expressed as defined daily dose (DDD) per 1000 inhabitants per day, were estimated using a random-effects model adjusted for income level and region. Relative changes in the annual consumption of psychotropic medicines by income, expressed as DDD per 1000 inhabitants per day, were assessed as percentage change for each medicine class. FINDINGS: Psychotropic medicine sales increased from 28·54 DDD per 1000 inhabitants per day in 2008 to 34·77 DDD per 1000 inhabitants per day in 2019, corresponding to a 4·08% (95% CI 2·96–5·21) relative average increase annually. The absolute annual increase was greater in high-income countries (3·31 DDD per 1000 inhabitants per day, 95% CI 3·01–3·61) compared with upper-middle-income countries (1·94 DDD per 1000 inhabitants per day, 1·45–2·44) and low-middle-income countries (0·88 DDD per 1000 inhabitants per day, 0·62–1·13; p<0·0001). The relative average annual increase in psychotropic medicine sales from 2008 to 2019 was greater in upper-middle-income countries (7·88%, 95% CI 6·99–8·77) than in lower-middle-income countries (2·90%, 2·40–3·39) and high-income countries (1·02%, 0·80–1·24). In 2019, the regional consumption of psychotropic medicines varied greatly, with the highest sales of all psychotropic medicine classes reported in northern America (167·54 DDD per 1000 inhabitants per day) and lowest sales reported in Asia (5·59 DDD per 1000 inhabitants per day). 17 countries had very low consumption of psychotropic medicines in 2019, including high-income countries and countries with a high prevalence of mental disorders. INTERPRETATION: The consumption of psychotropic medicines has increased over a 12-year period, and although the absolute growth rate was highest in high-income countries, the relative growth is highest in middle-income countries and especially upper-middle-income countries. Disparities in psychotropic medicine consumption of countries can only partly be explained by geographical location and income. Greater efforts are needed to increase the availability of psychotropic medicines in countries with very low consumption, which is probably due to financial or cultural reasons as well as scarcity of trained health-care professionals to prescribe psychotropic medicines. FUNDING: None. Elsevier Ltd. 2021-12 2021-11-18 /pmc/articles/PMC9766760/ /pubmed/34801129 http://dx.doi.org/10.1016/S2215-0366(21)00292-3 Text en © 2021 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Articles
Brauer, Ruth
Alfageh, Basmah
Blais, Joseph E
Chan, Esther W
Chui, Celine S L
Hayes, Joseph F
Man, Kenneth K C
Lau, Wallis C Y
Yan, Vincent K C
Beykloo, Maedeh Y
Wang, Zixuan
Wei, Li
Wong, Ian C K
Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title_full Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title_fullStr Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title_full_unstemmed Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title_short Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
title_sort psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9766760/
https://www.ncbi.nlm.nih.gov/pubmed/34801129
http://dx.doi.org/10.1016/S2215-0366(21)00292-3
work_keys_str_mv AT brauerruth psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT alfagehbasmah psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT blaisjosephe psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT chanestherw psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT chuicelinesl psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT hayesjosephf psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT mankennethkc psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT lauwalliscy psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT yanvincentkc psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT beykloomaedehy psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT wangzixuan psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT weili psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy
AT wongianck psychotropicmedicineconsumptionin65countriesandregions200819alongitudinalstudy