Evaluation of patient outcomes in an area where prescribing of anticholinergic antidepressants was influenced by academic detailing.
OBJECTIVE
To evaluate, on a patient level, the effect of a "physician-level intervention" that successfully reduced the incidence of anticholinergic antidepressant prescribing.


METHODS
Cross-sectional surveys with questionnaires sent before and after intervention.


METHODS
Additional study in an RCT to reduce the prescribing of highly anticholinergic antidepressants in the elderly in the South Holland Islands.


METHODS
Elderly patients (age 60-95 years) who used antidepressants in 1995 and 1996 in our research area according to a health insurance prescription database.


METHODS
Prevalence of adverse events related to antidepressant use, severity of depression and quality of life were compared in users living in the intervention and control areas.


RESULTS
Prior to our intervention we sent 2,359 questionnaires of which we could use 827 (35%) for analysis. At baseline, there were no statistically significant differences between the intervention and control areas. After the intervention 3,375 questionnaires were sent, of which 939 (28%) could be used. The occurrence of "dry mouth" and "coughing" and the "amount of pain" were lower in the intervention area compared to the control area (p < 0.05).


CONCLUSIONS
We found no indications that adverse events, severity of depression or quality of life were changed in an unfavourable direction, when comparing patients inside and outside the intervention area.
van Eijk
M E C
ME
Dutch Institute for the Effective Use of Medication DGV, 3502 GB Utrecht, The Netherlands. m.e.c.vanEijk@pharm.uu.n
Belitser
S V
SV
Porsius
A J
AJ
de Boer
A
A
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003625:Data Collection; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000928:Antidepressive Agents; D018680:Cholinergic Antagonists