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Preventive Medicine 2018 Journal of Preventive Medicine
ISSN: 2572-5483 Page 65
July 16-17, 2018
London, UK
9th Edition of International Conference on
Preventive Medicine
& Public Health
Background: Theaimwastodeterminetheeffectofantidepressant
outpatient consumption on the rate of hospitalization for
depression and to explore the role of family physician in the early
recognition and treatment of depression.
Methods: Using the WHO anatomical-therapeutic-chemical
classification/defined daily doses (ATC/DDD) methodology,
the number of DDD was calculated from data collected from all
Zagreb pharmacies on the number and size of drug packages
from 2001 to 2010. The rationality of prescribing was evaluated
by use of the Eurostat ratio indicators and the DU 90% method.
Hospitalization data were collected for every patient hospitalized
for depression.
Results: Outpatient utilization of antidepressants increased by
90% (11,4 DDD/TID vs. 20,59 DDD/TID). The highest rise was
recorded in the consumption of selective serotonin reuptake
inhibitors (SSRI) by 148%, with an increased proportion of
sertraline and fluvoxamine. Consumption of nonselective
inhibitors of monoamine reuptake was decreased by 68%. A rise
was recorded in the consumption of mirtazapine and venlafaxine
in particular. In Zagreb in 2010, even 6 of 8 antidepressants within
drug utilization 90% (DU90%) segment were from the SSRI group.
The anxiolytic/antidepressant ratio decreased from 6.45 in 2001
to 2.55 in 2010. The rate of hospitalization for depression has
significantly increased for 50%.
Conclusions: Although the overall outpatient utilization of
antidepressants increased during the study period, the rate of
hospitalization for depression increased as well. The decrease
in the utilization of anxiolytics with symptomatic action and the
increased utilization of antidepressants with etiologic action
points to improved psychopharmaceutical prescribing quality.
Continuous education of primary care physicians in early
detection and treatment of mild tomoderate depressive disorders
is required. Introduction of a questionnaire for early recognition
of depression symptoms at the primary healthcare level would
be highly useful. Depression is underdiagnose in primary
care; despite improvement observed in the prescribing quality,
continuous education of GP’s in early detection and treatment of
depression is required.
Utilization of antidepressants in Croatia: Is depression
underdiagnose in primary care?
Marina Polić-Vižintin1 , Ingrid Tripković2, Zvonimir Šostar 3 and Milana Smiljanić
Gaberšnik4
1Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia
2Teaching Institute of Public Health of Split and Dalmatia County, Croatia
3Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia
4Private pediatric practise, Croatia
J Prev Med 2018, Volume 3
DOI: 10.21767/2572-5483-C1-003