Abstract
BackgroundResearch suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups. This study aims to assess possible changes in the use of psychotropic drugs due to the economic recession in Portugal, by comparing self-reported consumption in 2008/09 and 2015/16.MethodsData from the World Mental Health Survey Initiative Portugal (2008/09) and the National Mental Health Survey Follow-Up (2015/16) were used (n = 911). McNemar’s tests were performed to estimate changes in consumption of any psychotropic drug and of antidepressants, anxiolytics, and hypnotics/sedatives. Multiple Generalised Estimating Equations models with interaction effects were used to estimate the population odds of consuming psychotropic drugs according to year, gender and age.ResultsAn increase of 6.74% was estimated in the consumption of psychotropic drugs from 2008/09 to 2015/16. Population odds of consuming any psychotropic drugs in 2015/16 were estimated to be 1.5 times higher than in 2008/09 (OR = 1.50;95%CI:1.13–2.01), particularly for hypnotics/sedatives (OR = 1.60;95%CI:1.14–2.25). Women and older individuals presented higher odds of consuming any psychotropic drugs (OR = 2.79;95%CI:2.03–3.84, and OR = 1.80;95%CI:1.28–2.54), after adjusting for year of assessment and education. However, when evaluating the interaction effect of the year with gender and age, men and younger individuals reported higher odds of consuming any psychotropic drugs in 2015/16, when compared to 2008/09 (OR = 1.85;95%CI:1.08–3.17, and OR = 1.95;95%CI:1.32–2.90, respectively).ConclusionsThe findings indicate that the period of economic recession was associated with an increased risk of psychotropic drugs use in Portugal. Consumption of psychotropic drugs remained higher among women and older individuals, but the results suggest that the economic crisis had a disproportionate impact on men and younger individuals. This identification of the most vulnerable population groups is useful to design effective and targeted public health interventions aimed at alleviating the effects of economic recessions.
Highlights
Research suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups
Consumption of psychotropic drugs remained higher among women and older individuals, but the results suggest that the economic crisis had a disproportionate impact on men and younger individuals
Given the scarce evidence and the public health importance of this topic in the Portuguese context, this study aims to assess possible changes in the use of psychotropic drugs indicated for the treatment of common mental disorders, the clinical situations predictably most affected by economic recessions [13, 14]
Summary
Research suggests that economic recessions might be associated with a higher use of psychotropic drugs, but literature is scarce and contradictory in identifying the most vulnerable groups. This study aims to assess possible changes in the use of psychotropic drugs due to the economic recession in Portugal, by comparing selfreported consumption in 2008/09 and 2015/16. Measures included increase in co-payments for pharmaceuticals, generic drugs promotion campaigns, electronic prescription, and discounts granted to the public payer [3, 6, 7]. These measures tend to shift the cost-burden to those who needed medicines, in a country where out-of-pocket payments already represented an important part of total health care expenditure [8, 9]. Concerns arose about the unintended risk of less equitable access to needed medicines and “cost-related non-adherence” [10, 11]
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