Antidepressant use habits in rural regions: a multi-center research

Abstract

Objective: Rural areas have specific dynamics. Limited access to major health centers increases the importance of primary care in these regions. Antidepressants (AD) are used widely in the world. More than half of the antidepressants are prescribed in the primary care. This study examines AD use dynamics in rural areas. Methods: A cross-sectional, survey research was conducted with 174 patients in three different rural areas. Fourteen questions (10 for ADs and 4 for demographic data) were asked to each participant. The data were evaluated using the SPSS 15.0 statistical package program with frequency-values, chi-square test and t-test. Results: One hundred and thirty-one women (75.3%) and 43 men (24.7%) were participated in the study. Thirty five percent of the participants were using ADs for 1-5 years. The most frequent reason of starting ADs was nervousness (44.3%). Women were 8 times more likely to start ADs for headaches. Civil servants had the highest income. The most common AD drug was escitalopram (35.1). The most frequent institutions that AD use initiated was the state hospitals (43.1%). Patients were likely to use AD long term if they were initiated by mental hospitals. One in 10 AD user thought the drug was unnecessary. Conclusion: Conditions associated with the use of ADs in our study were female gender, being married, being a family member of women using ADs, living in crowded families and poverty. Participants who had the certificate of long term drug use (CLD) were more likely to use ADs one year or more. Low AD use among our patients may suggest people are healthier mentally in rural areas. The main reason of continuing AD was doctor advice among patients who thought the AD was unnecessary. Sociocultural, economic dynamics and the qualifications of the primary care physicians can affect AD use in rural areas.