The role of general practitioners and psychiatrists in issuing initiation and follow-up prescriptions for selective serotonin (norepinephrine) reuptake inhibitors in Germany

AIM: The aim of this study was to investigate the prescribing patterns of selective serotonin (norepinephrine) reuptake inhibitors (SS(N)RI) in patients treated by general practitioners (GPs) or neurologists/psychiatrists (NPs). MATERIALS AND METHODS: In this retrospective study, we identified patients who received an initial prescription (Rx) of SSRI or SSNRI in 2016 (index date) documented in the IMS® LRx longitudinal pharmacy database. The primary outcome was the proportion of patients who received Rxs from both a GP and an NP, and who switched the prescriber within 1 year after the index date. RESULTS: In total, 345,996 patients (mean age = 55.2 years, 66.4% female) were eligible for analysis, of whom 57.6% received their first Rx from a GP. Over 30% of the patients only received 1 SS(N)RI Rx during the retrospective follow-up period. Of the patients who received at least 2 Rxs, 26.3% received an Rx from both a GP and an NP. This percentage was higher in patients who received their first Rx from an NP (28.4% vs. 24.5%). Multivariate regression analyses showed that younger patients, patients initially treated by an NP, and patients with previous antidepressant prescriptions were more likely to switch prescribers, as were patients who initiated treatment with sertraline or venlafaxine. CONCLUSION: GPs prescribed ~ 60% of the initial SS(N)RI in the year 2016. A fourth of all patients who received at least 2 Rxs switched to another prescriber during follow-up. This switch was associated with age, the type of SS(N)RI prescribed, physician, and previous antidepressant Rxs.
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