OBJECTIVES: To analyze the therapeutic pathways and healthcare resource utilization for patients affected by depression in Veneto Region (Italy).

METHODS: Administrative database of Veneto Region (Italy) was retrospectively analyzed; all patients with at least two prescriptions of antidepress ant (AD) drug between January 2012 and June 2016 were included in the study and followed-up for 12 months (follow-up period). Treatment adherence was calculated by using Defined Daily Dose (DDD)and defined as AD prescriptions covering ≥80% compliant days during the follow-up period. Therapeutic switches, add-on and prescription of cardiovascular agents (statins, antihypertensives and antidiabetics) were also analyzed.

RESULTS: A total of 296,769 patients (overall population 4.9 million of inhabitants, prevalence 6%), mean age of 60.9 years (46% aged ≥65 years), 31.8% male were included in the study. Among AD classes, Selective Serotonin Reuptake Inhibitors (SSRIs) were most frequently prescribed (80.5%), whereas 16.5% of patients received Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs), 1.6% received Tricyclic Antidepressants (TCAs) and 1.4% Other AD agents. 11.3% of patients required a therapeutic switch in AD, 4.7% of patients required an add-on AD therapy. 49% of all patients in the analysis had ≥80% adherence to AD during the follow-up. The worst adherence level was measured in TCAs (35%) and the best in SSRI (50%). Incidence of antihypertensive treatment in AD treatment naïve patients (no AD prescriptions before inclusion date) was higher (5.1% of SSRI, 6.1% of SNRI, 7.4 of TCA, 6.5% of Other AD patients) compared to statins and antidiabetics.

CONCLUSIONS: The results from the present real-world analysis in Veneto Region of Italy suggest that adherence to AD treatment represents an issue for all the available classes of ADs. Moreover, a non-negligible portion of treatement naïve patients receiving an AD also received a cardiovascular agent.