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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Patricia N. Pastor, PhD and Henry Xia. National Center for Health Statistics, Centers for Disease Control, 6525 Belcrest Road, Room 775, Hyattsville, MD 20782, (301)458-4422, php3@cdc.gov
Introduction: Providing services for the diagnosis and treatment of mental illness is critical for the health of the nation. To develop more effective policies and programs for mental health services, information about the current patterns of mental health care is essential. The aim of the present study is to examine changes in the prescription of psychotropic medications in ambulatory care between 1993-94 and 1998-99 by examining the rate of visits involving all categories of psychotropic drugs, antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Changes in the rate of psychotropic drug visits by physician specialty or setting (primary care, osteopathy, psychiatry, other medical specialties, and hospital outpatient clinics) are described. Differences by age, gender, geographical region, and metropolitan status are also presented. Methods: Estimates are based on combined data from the National Ambulatory Medical Care Survey, a nationally representative sample of visits to office-based physicians, and the outpatient component of the National Hospital Ambulatory Medical Care Survey, a national sample of visits to outpatient departments of general and short-stay hospitals. SUDAAN was used to adjust for the effect of the complex sampling design on variance estimates. Rates of drug visits (number of visits per 1,000 persons in the population) for all psychotropic drugs, antidepressants, and SSRIs were calculated using a listing of drugs for the treatment of mental illness (updated to 2000). A psychotropic drug visit is one in which at least one psychotropic drug was prescribed, ordered, supplied, administered, or continued. Results: Between 1993-94 and 1998-99, the average annual number of ambulatory drug visits (in millions) increased for all psychotropic drugs from 49.9 to 72.8, for antidepressants from 27.0 to 47.5, and for SSRIs from 14.0 to 27.9. By 1998-99, 65% of all psychotropic drug visits included the prescription of an antidepressant and 38% the prescription of a SSRI. The rate of psychotropic drug visits and antidepressant visits (visits per 1,000 persons) rose over this five-year period for persons of all ages. Overall, the psychotropic drug visit rate increased from 191 to 269 and the antidepressant visit rate 103 to 176. The rate of psychotropic drug visits showed increases for office visits to primary care physicians, osteopaths, and medical specialists other than psychiatrists, and visits to hospital outpatient clinics. Conclusions: Ambulatory care visits including psychotropic medications, especially antidepressants, increased from 1993-94 to 1998-99 indicating a continuation of the trend previously shown for the years 1985 to 1993-94.
Learning Objectives: At the conclusion, the participant will be able to
Keywords: Mental Health Care, Prescription Drug Use Patterns
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.