Original scientific paper

COMPARISON OF DEPRESSION TREATMENT AMONG DIFFERENT AGE GROUPS IN PRIMARY CARE SETTING

Sanja Blažeković-Milaković ; Department of Family Medicine, Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
Stanislava Stojanović-Špehar ; Department of Family Medicine, Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
Milica Katić ; Department of Family Medicine, Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
Suzana Kumbrija ; Department of Family Medicine, Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

Background: The aim of this study was to explore the association between age and care of patients with depression in primary
care setting. A comparison was made among the groups of elderly patients, middle aged patients and younger patients with diagnosis
of depressive episode (F32).
Subjects and Methods: Patients (17.290) from ten GP offices in the city of Zagreb formed the representative sample for this
study according to the estimated depression prevalence in Europe of 5%. A group of 231 (60%) patients with diagnosis Depressive
episode (F32), out of 383 patients with Depression diagnosis according to ICD-10, were reviewed and extracted from GPs’
standardized medical files. They were divided in three age groups: <45 years (n=58), 45-65 years (n=97) and >65 years (n=76).
Data were tracked longitudinally and obtained retrospectively for one-year period from 1st January to 31th December 2009.
Pharmacotherapy was classified according to the Anatomical Therapeutic Chemical (ATC) classification index.
Results: The youngest and the oldest age group mainly used only one drug in their therapy (47% vs- 64%), but middle age group
almost equally used one or two drugs (42 vs 45%). About 50% of all patients used SSRIs. Benzodiazepines were used most frequently
in middle and in the oldest age group (71% vs 60%). The most frequent combinations of antidepressants in the youngest age group
were SSRIs and combination of SSRIs and benzodiazepines; in middle age group it was combination of SSRIs and benzodiazepines
and benzodiazepines; and in the oldest benzodiazepines, and SSRIs. Benzodiazepines were used mainly discontinuously in oppose to
significant continuous usage in middle age group (P 0,043). In the oldest age groupe, depression diagnose was mostly given by GP
and the most frequent therapy was combination of pharmacotherapy and GP's support. Unaided clinical assessment of depression
outcome by GP did not differ significantly between age groups although some differences existed.
Conclusion: Number and sort of antidepressants as well as sort of physician: GP or psychiatrist differed between age groups of
depressed patients. Further investigation of specifical depression treatment compared with outcome measures should give answer
whether those differences are justified.

Keywords

pharmacotherapy; depression; age groups

Hrčak ID:

76816

URI

https://hrcak.srce.hr/76816

Publication date:

30.6.2011.

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