title: Antidepressants utilization among elderly in Lombardy from 2000 to 2007: dispensing trends and appropriateness.
abstract: OBJECTIVE
  To investigate the prevalence and incidence of antidepressant (AD) use in the elderly during an 8-year period and to evaluate AD treatment appropriateness.
  
  
  METHODS
  A population-based dispensation study on community-dwelling elderly of a large area in Lombardy was performed. Data were drawn from the regional administrative database and from a general practice registry. For each year, prevalence of AD use (i.e., at least one recorded dispensation) and AD treatment (i.e., at least four recorded dispensations) was compared.
  
  
  RESULTS
  The prevalence of AD use and treatment doubled and tripled, respectively. The greatest shift occurred between 2000 and 2002 and was entirely due to SSRIs. The most pronounced increase was seen in females who accounted for 72% of all dispensations. The increase in prevalence was not mirrored by incident use, which slightly decreased (OR: 0.98; 95% CI: 0.98-0.98). The proportion of those who received a minimally adequate AD treatment grew over the years (OR: 1.63; 95% CI: 1.59-1.68). The increase in prevalence of AD treatment was most pronounced among older age groups (ORs between 1.02 and 1.06 for age classes ≥75 years relative to the 65-69 age class; P < 0.001) and was proportional to that of depressive disorders.
  
  
  CONCLUSIONS
  A dramatic rise in dispensations was observed. The increasing prevalence of minimally adequately treated subjects and a possible decrease in untreated depression may reflect an improvement in the pharmacological treatment of depression. The increase in prevalence and not in the incidence of dispensations could be related to an inappropriate prolongation of treatment duration.
authors.affiliation: Mario Negri Institute for Pharmacological Research, Via La Masa 19, 20156 Milan, Italy. alberto.parabiaghi@marionegri.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Parabiaghi
authors.forename: Carlotta
authors.initials: C
authors.lastname: Franchi
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.forename: Angelo
authors.initials: A
authors.lastname: Barbato
authors.forename: Barbara
authors.initials: B
authors.lastname: D'Avanzo
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage*; D003866:Depressive Disorder / Q000188:drug therapy*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D010594:Pharmacies; D015995:Prevalence; D012042:Registries; D012111:Residence Characteristics; D012189:Retrospective Studies
chemical_list: D000928:Antidepressive Agents