title: Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications.
abstract: OBJECTIVE
  Drug utilization studies have applied different methods to various data types to describe medication use, which hampers comparisons across populations. The aim of this study was to describe the time trends in antidepressant prescribing in the last decade and the variation in the prevalence, calculated in a uniform manner, in seven European electronic healthcare databases.
  
  
  METHODS
  Annual prevalence per 10,000 person-years (PYs) was calculated for 2001-2009 in databases from Spain, Germany, Denmark, the United Kingdom (UK), and the Netherlands. Prevalence data were stratified according to age, sex, antidepressant type (selective serotonin re-uptake inhibitors [SSRIs] or tricyclic antidepressants [TCAs]) and major indications.
  
  
  RESULTS
  The age- and sex-standardized prevalence was lowest in the two Dutch (391 and 429 users per 10,000 PYs) and highest in the two UK (913 and 936 users per 10,000 PYs) populations in 2008. The prevalence in the Danish, German, and Spanish populations was 637, 618, and 644 users per 10,000 PY respectively. Antidepressants were prescribed most often in 20- to 60-year-olds in the two UK populations compared with the others. SSRIs were prescribed more often than TCAs in all except the German population. In the majority of countries we observed an increasing trend of antidepressant prescribing over time. Two different methods identifying recorded indications yielded different ranges of proportions of patients recorded with the specific indication (15-57% and 39-69% for depression respectively).
  
  
  CONCLUSIONS
  Despite applying uniform methods, variations in the prevalence of antidepressant prescribing were obvious in the different populations. Database characteristics and clinical factors may both explain these variations.
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, P.O. Box 80 082, Utrecht, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: Abbing-Karahagopian
authors.forename: C
authors.initials: C
authors.lastname: Huerta
authors.forename: P C
authors.initials: PC
authors.lastname: Souverein
authors.forename: F
authors.initials: F
authors.lastname: de Abajo
authors.forename: H G M
authors.initials: HG
authors.lastname: Leufkens
authors.forename: J
authors.initials: J
authors.lastname: Slattery
authors.forename: Y
authors.initials: Y
authors.lastname: Alvarez
authors.forename: M
authors.initials: M
authors.lastname: Miret
authors.forename: M
authors.initials: M
authors.lastname: Gil
authors.forename: B
authors.initials: B
authors.lastname: Oliva
authors.forename: U
authors.initials: U
authors.lastname: Hesse
authors.forename: G
authors.initials: G
authors.lastname: Requena
authors.forename: F
authors.initials: F
authors.lastname: de Vries
authors.forename: M
authors.initials: M
authors.lastname: Rottenkolber
authors.forename: S
authors.initials: S
authors.lastname: Schmiedl
authors.forename: R
authors.initials: R
authors.lastname: Reynolds
authors.forename: R G
authors.initials: RG
authors.lastname: Schlienger
authors.forename: M C H
authors.initials: MC
authors.lastname: de Groot
authors.forename: O H
authors.initials: OH
authors.lastname: Klungel
authors.forename: T P
authors.initials: TP
authors.lastname: van Staa
authors.forename: L
authors.initials: L
authors.lastname: van Dijk
authors.forename: A C G
authors.initials: AC
authors.lastname: Egberts
authors.forename: H
authors.initials: H
authors.lastname: Gardarsdottir
authors.forename: M L
authors.initials: ML
authors.lastname: De Bruin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents