title: Drug utilization trends in patients with posttraumatic stress disorder in a postconflict setting: consistency with clinical practice guidelines.
abstract: OBJECTIVE
  The objective of this study was to compare observed patterns of drug utilization among patients with posttraumatic stress disorder (PTSD) in a postconflict setting with current guidelines and to present baseline period prevalence and change in period prevalence from 2 time periods, 2002 and 2012.
  
  
  METHODS
  The study provides details of the annual number of patients with PTSD with at least 1 redeemed prescription containing the diagnostic code F43.1 according to International Classification of Diseases (ICD-10) for fiscal years 2002 through 2012 in Croatia. Using longitudinal data analysis, overall change in medication use frequency was calculated for each medication and therapeutic subgroup classified by the Anatomic Therapeutic Chemical classification system according to absolute frequency.
  
  
  RESULTS
  Over the 11-year study period, the number of patients receiving pharmacotherapy associated with PTSD increased 7-fold. The annual frequency of drug use was highest for anxiolytics, with use of anxiolytics increasing from 73.32% in 2002 to 75.83% in 2012; antidepressants, from 44.56% to 61.36%; hypnotics, from 18.67% to 35.68%; and antipsychotics, from 21.81% to 30.21%. Overall change in drug utilization frequency was most prominent for hypnotics (17.01%), antidepressants (16.80%), and antipsychotics (8.40%) during the period 2002-2012.
  
  
  CONCLUSIONS
  Drug utilization trends in our postconflict setting were predominantly inconsistent with current guidelines for treatment of PTSD due to excessive anxiolytic use, implying that psychopharmacotherapy was used mainly for tranquilizing properties to address non-diagnosis-specific symptoms. Promising rising trends in utilization of antidepressants were not followed with compensatory reductions in anxiolytic use. These data revealed areas of inconsistent use of drugs, generating suggestions for interventions to improve drug use and also hypotheses for additional research.
authors.affiliation: Department of Psychiatry, School of Medicine, University of Rijeka, University Hospital Centre Rijeka, Cambierieva 17, 51000 Rijeka, Croatia marinalc@medri.uniri.hr.
authors.forename: Marina
authors.initials: M
authors.lastname: Letica-Crepulja
authors.forename: Nenad
authors.initials: N
authors.lastname: Korkut
authors.forename: Tanja
authors.initials: T
authors.lastname: Grahovac
authors.forename: Jelena
authors.initials: J
authors.lastname: Curac
authors.forename: Ksenija
authors.initials: K
authors.lastname: Lehpamer
authors.forename: Tanja
authors.initials: T
authors.lastname: Franciskovic
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D017523:Croatia / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D014857:Warfare
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs