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Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark
OBJECTIVES: Off‐label prescriptions of antidepressants may be of special concern in older‐adults. We aimed to study the potential off‐label use of antidepressants among adults ≥65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications. MET...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828742/ https://www.ncbi.nlm.nih.gov/pubmed/36378540 http://dx.doi.org/10.1002/gps.5841 |
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author | Ishtiak‐Ahmed, Kazi Liu, Xiaoqin Christensen, Kaj Sparle Gasse, Christiane |
author_facet | Ishtiak‐Ahmed, Kazi Liu, Xiaoqin Christensen, Kaj Sparle Gasse, Christiane |
author_sort | Ishtiak‐Ahmed, Kazi |
collection | PubMed |
description | OBJECTIVES: Off‐label prescriptions of antidepressants may be of special concern in older‐adults. We aimed to study the potential off‐label use of antidepressants among adults ≥65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications. METHODS: We used registry data to describe indications of all antidepressant prescriptions (N = 13.8 million) redeemed by older‐adults in 2006–2019. We investigated factors associated with off‐label use by considering prescriptions with missing and unspecified indications of the first antidepressant prescription using a multinomial logistic regression with the ‘depression’ indication as a reference category and reported odds ratios (ORs) with 95% confidence intervals (CI). RESULTS: Overall, 18.1% of all antidepressant prescriptions had missing indications, and 9.9% had unspecified indications. The proportion of potential off‐label use based on missing and unspecified prescriptions remained mostly consistent during 2006–2019. We identified similar associations in user characteristics whether considering missing or unspecified first prescription. ORs with 95% CI were raised in non‐western ethnicity (vs. Danish, 1.12 (0.99–1.26) for missing indication and 1.28 (1.11–1.48) for unspecified indication) and female sex (vs. male, 1.05 (1.02–1.07) and 1.05 (1.02–1.07) respectively). ORs were reduced for shorter educational attainment (vs. long, 0.90 (0.87–0.94) and 0.92 (0.88–0.96)), older age (≥81 vs. 67–70 years, 0.66 (0.65–0.71) and 0.73 (0.70–0.76)) and hospital psychiatric diagnosis (per diagnosis 0.76 (0.73–0.78) and 0.88 (0.86–0.91)). CONCLUSIONS: Nearly one‐third of all antidepressant prescriptions redeemed by older‐adults in Denmark had either missing or unspecified treatment indications. Whether these prescriptions were actual off‐label use needs to be validated. Clinicians should pay special attention to patients' characteristics linking missing and unspecified indications and maintain adequate documentation while prescribing medication. |
format | Online Article Text |
id | pubmed-9828742 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98287422023-01-10 Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark Ishtiak‐Ahmed, Kazi Liu, Xiaoqin Christensen, Kaj Sparle Gasse, Christiane Int J Geriatr Psychiatry Research Article OBJECTIVES: Off‐label prescriptions of antidepressants may be of special concern in older‐adults. We aimed to study the potential off‐label use of antidepressants among adults ≥65 years by describing the patterns, trends, and factors associated with missing and unspecified treatment indications. METHODS: We used registry data to describe indications of all antidepressant prescriptions (N = 13.8 million) redeemed by older‐adults in 2006–2019. We investigated factors associated with off‐label use by considering prescriptions with missing and unspecified indications of the first antidepressant prescription using a multinomial logistic regression with the ‘depression’ indication as a reference category and reported odds ratios (ORs) with 95% confidence intervals (CI). RESULTS: Overall, 18.1% of all antidepressant prescriptions had missing indications, and 9.9% had unspecified indications. The proportion of potential off‐label use based on missing and unspecified prescriptions remained mostly consistent during 2006–2019. We identified similar associations in user characteristics whether considering missing or unspecified first prescription. ORs with 95% CI were raised in non‐western ethnicity (vs. Danish, 1.12 (0.99–1.26) for missing indication and 1.28 (1.11–1.48) for unspecified indication) and female sex (vs. male, 1.05 (1.02–1.07) and 1.05 (1.02–1.07) respectively). ORs were reduced for shorter educational attainment (vs. long, 0.90 (0.87–0.94) and 0.92 (0.88–0.96)), older age (≥81 vs. 67–70 years, 0.66 (0.65–0.71) and 0.73 (0.70–0.76)) and hospital psychiatric diagnosis (per diagnosis 0.76 (0.73–0.78) and 0.88 (0.86–0.91)). CONCLUSIONS: Nearly one‐third of all antidepressant prescriptions redeemed by older‐adults in Denmark had either missing or unspecified treatment indications. Whether these prescriptions were actual off‐label use needs to be validated. Clinicians should pay special attention to patients' characteristics linking missing and unspecified indications and maintain adequate documentation while prescribing medication. John Wiley and Sons Inc. 2022-11-15 2022-12 /pmc/articles/PMC9828742/ /pubmed/36378540 http://dx.doi.org/10.1002/gps.5841 Text en © 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Ishtiak‐Ahmed, Kazi Liu, Xiaoqin Christensen, Kaj Sparle Gasse, Christiane Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title | Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title_full | Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title_fullStr | Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title_full_unstemmed | Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title_short | Treatment indications and potential off‐label use of antidepressants among older adults: A population‐based descriptive study in Denmark |
title_sort | treatment indications and potential off‐label use of antidepressants among older adults: a population‐based descriptive study in denmark |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828742/ https://www.ncbi.nlm.nih.gov/pubmed/36378540 http://dx.doi.org/10.1002/gps.5841 |
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