Key result
Patient age significantly predicted the choice of antidepressant molecule in 8 of 11 medications investigated, while gender influenced the prescribing of 6 different molecules.
Why the study?
Evidence is limited regarding the factors influencing antidepressant prescription for major depressive disorder in real-world clinical practice in Italy.
Observational (n=8,823)
In a real-world Italian primary care setting, patient age and gender were significant predictors of the specific antidepressant molecule prescribed for major depressive disorder.
Age and gender influence antidepressant selection in primary care; hypothesis-generating for potential biases, requiring prospective validation before practice implications.
OBJECTIVES: There is limited evidence about the factors influencing antidepressant (AD) prescription for the treatment of major depressive disorder (MDD) in Real World clinical practice in Italy. In this retrospective, population-based study, we set out to describe a patient cohort initiated on AD treatment for MDD and investigate the possible predictors of different AD prescriptions in the primary care setting. METHODS: Patients with a diagnosis of MDD who received an initial prescription of one of 11 selected ADs between 1-Apr-2017 and 31-Mar-2019 (index date) were identified from primary care electronic medical records in the Longitudinal Patient Database. Patients prescribed ≥1 AD in the 12 months before the index date were excluded. Results were stratified by AD molecule. Multivariable logistic regression models estimated the association between patients' demographic, clinical factors, and choice of AD molecule. RESULTS: The study cohort comprised 8,823 patients (67.1% female; mean age 61.6 years). Previous AD treatments (prescribed in the 10 years before the index date) had been received by 46.6% of patients (non-naïve patients). The most commonly reported psychiatric and medical comorbidities reported in the 12 months before the index date were anxiety (8.4%) and hypertension (41.9%), respectively. Patients' age was a significant predictor of AD molecule prescribed at index date in eight of the 11 molecules investigated, while patients' gender influenced clinician prescribing bupropion, citalopram, fluoxetine, fluvoxamine, sertraline, and vortioxetine. CONCLUSION: Results from this Real World study provide useful information for clinicians on the clinical factors influencing AD prescription in patients treated for MDD in primary care.
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Martinotti et al. (2022) conducted an observational in Major Depressive Disorder (n=8,823). Antidepressant prescription was evaluated on Predictors of antidepressant molecule prescription. Patient age significantly predicted the choice of antidepressant molecule in 8 of 11 medications investigated, while gender influenced the prescribing of 6 different molecules.
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