Treatment indications for antidepressants prescribed in primary health care facilities in Beijing, China.

Abstract

To examine the prevalence of treatment indications for antidepressants and assessed temporal trends in antidepressant prescribing for depression among adult patients in primary health care facilities (PHFs) in China. Descriptive study of antidepressant prescriptions written by primary care physicians. Setting participants: Patients aged 18 years and above in 67 PHFs in Dongcheng district in Beijing between 1 January 2014 and 31 December 2022. Deidentified information including patient demographics,antidepressants prescribed,and corresponding diagnoses were extracted from the prescribing system. The primary outcome was the treatment indications for all antidepressants prescribed between 2014 and 2022. Prescriptions were classified as on-label or off-label depending on whether the drug was approved for the indication by China's National Medical Products Administration by September 2022. A total of 42379 antidepressant prescriptions were identified between 2014 and 2022. Only 21.21 % of antidepressant prescriptions were indicated for depression. Anxiety disorders (31.43 %), insomnia (20.07 %), pain(19.12 %) and digestive system disorders (16.34 %) are also frequently prescribed antidepressants by physicians. For these indications, the most frequently prescribed antidepressant was flupentixol/melitracen and sertraline.For 36.32 % of all antidepressant prescriptions,physicians prescribed a drug for an off-label indication,especially insomnia and pain.Physicians also prescribed antidepressants for several indications that were off-label for all antidepressants, including digestive system disorders and migraine. This study found compound antidepressants are widely prescribed and used off-label indications.There is a need for more evidence to evaluate the clinical outcomes associated with off-label antidepressant indications for older adults to optimise prescribing decisions at PHFs.