title: Use of antidepressant medication after road traffic injury.
abstract: OBJECTIVE
  Mental ill health after road traffic injury is common, as is the use of antidepressant medication after injury. Little is known about antidepressant use by injured people prior to their injury. The aim of this study is to describe the nature and extent of antidepressant use before and after road traffic injury.
  
  
  METHODS
  Victorian residents who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 and provided consent for Pharmaceutical Benefits Scheme (PBS) linkage were included (n=734). PBS records dating from 12 months prior through to 12 months post injury were provided by the Department of Human Services (Canberra). PBS and TAC claims data were linked.
  
  
  RESULTS
  Among participants, 12% used antidepressants before injury (84.4D efined Daily Doses/1000 person-days) and 17% used antidepressants after injury (114.1DDD/1000p-d). Only 7.7% of the injured cohort commenced antidepressant treatment post injury. Thus, of all post-injury antidepressant use, 45% could potentially be related to the incident injury, with the remaining 55% most probably a continuation of pre-injury use. Pre-injury use was more common among women (109.4 vs. 54.6 DDD/1000p-d, p<0.0001), and those with whiplash injury (119.3 vs. 73.1, p=0.03). Cyclists and motorcyclists were less likely to use antidepressants pre-injury than car drivers (18.3 vs. 16.9 vs. 109.3, respectively; p<0.001).
  
  
  CONCLUSIONS
  Less than half of post-injury antidepressant use could potentially be attributable to the incident injury. These results highlight the importance of obtaining information on pre-injury health status before interpreting post-injury health service use to be an outcome of the injury in question.
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Australia. Electronic address: janneke.berecki-gisolf@monash.edu.au.
authors.forename: Janneke
authors.initials: J
authors.lastname: Berecki-Gisolf
authors.affiliation: Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Collie
authors.affiliation: Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Hassani-Mahmooei
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Population Health, Boston, USA.
authors.forename: Roderick
authors.initials: R
authors.lastname: McClure
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D008297:Male; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D014911:Whiplash Injuries / Q000150:complications / Q000188:drug therapy* / Q000523:psychology
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Compensable injury; Injury outcomes; Road trauma