Abstract
Background: Comorbid anxiety and depression and type two diabetes mellitus (T2DM) are commonly managed by General Practitioners (GPs).Objectives: To investigate the proportion of people with T2DM who are prescribed either antidepressant or benzodiazepine medications in general practice; to compare people with T2DM that have a prescription with those that do not in terms of patient characteristics, glycaemic control and healthcare utilization.Methods: Anonymized data was collected by GPs and senior medical students from electronic medical records of patients with T2DM in 34 Irish general practices affiliated with the University of Limerick Graduate Entry Medical School during the 2013/14 academic year. Data included demographics, healthcare utilization, prescriptions and most recent glycosylated haemoglobin (HbA1c) measurement.Results: The sample included 2696 patients with T2DM, of which 733 (36.7%) were female, and with a median age of 66 years. The percentage with a current prescription for an antidepressant or benzodiazepine was 22% (95%CI: 18.9–24.9). Those with a current prescription for either drug were more likely to have attended the emergency department (28.3% vs 15.7%, P <0.001), to have been admitted to hospital (35.4% vs 21.3%, P <0.001) in the past year and attend their GP more frequently (median of 9 vs 7, P <0.001) than those without a prescription. Rates of poor glycaemic control were similar in those with and without a current prescription.Conclusion: Over one-fifth of people with T2DM in Irish general practice are prescribed an antidepressant or benzodiazepine medication. Prescription of these is associated with increased healthcare utilization but not poorer glycaemic control.
Highlights
Depression and anxiety frequently co-exist in the general population and commonly occur in people with diabetes mellitus with the presence of one increasing the risk of developing the other [1,2]
Healthcare utilization in the previous year: total number of General Practitioners (GPs) consultations where a consultation is defined as any visit or telephone conversation that resulted in an entry to patient records; any attendance to the emergency department; any hospital admission; any referral or attendance to specialist mental health services; any referral or attendance to an endocrinologist most recent measurement of HbA1c in mmol/mol
The proportion of patients with a current prescription for antidepressants or benzodiazepines was estimated with a 95%CI for the proportion, using the SAS procedure SURVEYFREQ to account for clustering of patients within practices
Summary
Depression and anxiety frequently co-exist in the general population and commonly occur in people with diabetes mellitus with the presence of one increasing the risk of developing the other [1,2]. Treating most people with T2DM and comorbid depression and anxiety, frequently prescribing benzodiazepine and antidepressant medications [5,6]. Comorbid anxiety and depression and type two diabetes mellitus (T2DM) are commonly managed by General Practitioners (GPs). Objectives: To investigate the proportion of people with T2DM who are prescribed either antidepressant or benzodiazepine medications in general practice; to compare people with T2DM that have a prescription with those that do not in terms of patient characteristics, glycaemic control and healthcare utilization. Conclusion: Over one-fifth of people with T2DM in Irish general practice are prescribed an antidepressant or benzodiazepine medication Prescription of these is associated with increased healthcare utilization but not poorer glycaemic control
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