Status: Planned
First registered on:
19/05/2017
Last updated on:
01/06/2017
1. Study identification
EU PAS Register NumberEUPAS19188
Official titleUse of antidepressant drugs and its association with risk of stroke, frequency of hospitalization, and mortality in an elderly population: a descriptive and analytic cohort study
Study title acronym
Study typeObservational study
Brief description of the studyThis is an observational study which will describe the use of antidepressants in an elderly population and assess its association with stroke, hospitalizations due to stroke and death in an elderly population during 2009-2015.
A retrospective descriptive drug utilization study in a population aged over 65 and registered in the System for the Development of Research in Primary Care database (SIDIAP). Demographic and clinical patient characteristics, selected co-morbidities, clinical indications of antidepressant use, prescribed active ingredient of antidepressant, selected co-medications, prescribed dose and duration of antidepressants, switchers and discontinuers will be described. Prevalence of antidepressant use and rate of switchers and discontinuers will be measured.
A retrospective study with matched cohorts will be conducted in a population aged over 65 and registered in the System for the Development of Research in Primary Care database (SIDIAP). Cases are incident users of antidepressant medication (tricyclic antidepressants, selective serotonin reuptake inhibitors, and other antidepressants), controls will not have used this type of medication. The research will evaluate the association of new prescription of antidepressants for any indication and occurrence of first episode of stroke, hospitalization or death. The information will be obtained from SIDIAP database (which has information of 5.8 million primary care patients from Intitut Català de la Salut), DATAMART® database (Pharmaceutical dispensation information from Catalan Health Service) and CMBD database (Hospital discharge registry from General Hospital of National Health System).
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
Not applicable
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Centre to which the investigator belongsFICF
Department/Research group
Organisation/affiliationFundació Institut Català de Farmacologia
Details of (Primary) lead investigator
Title Dr
Last name Ibañez
First name Luisa
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
National study
Spain
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed14/07/2015
Start date of data collection01/06/201613/09/2016
Start date of data analysis
Date of interim report, if expected
Date of final study report31/12/2018
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
Charities
Government bodyInstituto de Salud Carlos III50
Research councils
EU funding schemeEuropean Regional Development Fund (FEDER))50
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Ibañez
First name Luisa
Address line 1Vall d'Hebron 119-129
Address line 2Antiga Escola Infermeria
Address line 3Servei de Farmacologia Clínica
CityBarcelona
Postcode08039
CountrySpain
Phone number (incl. country code)34934894105
Alternative phone number34934894305
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Ibañez
First name Luisa
Address line 1Vall d'Hebron 119-129
Address line 2Antiga Escola Infermeria
Address line 3Servei de Farmacologia Clínica
CityBarcelona
Postcode08039
CountrySpain
Phone number (incl. country code)34934894105
Alternative phone number34934894305
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)N06AA (Non-selective monoamine reuptake inhibitors)
Substance class (ATC Code)N06AB (Selective serotonin reuptake inhibitors)
Substance class (ATC Code)N06AX (Other antidepressants)
Substance class (ATC Code)N06CA (Antidepressants in combination with psycholeptics)
7. Medical conditions to be studied
Medical condition(s)Yes
Death
Haemorrhagic stroke
Ischaemic stroke
Cerebellar stroke
Hospitalisation
8. Population under study
Age
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects417685
Additional information
89537 exposed and 328148 nonexposed (controls)
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Administrative database, e.g. claims database
Routine primary care electronic patient registry
Hospital Discharge Records linked with the database from SIDIAP
11. Scope of the study
What is the scope of the study?
Risk assessment
Drug utilisation study
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
Drug U: To describe the incident use of antidepressant drugs in a population ≥65 years old during the period of 2009-2015.
Risk A: To compare time to occurrence of the composite outcome variable: first episode of nonfatal stroke, fatal stroke, hospitalization due to stroke, or death from any cause among elderly new users and nonusers of SSRI antidepressant drugs
Are there primary outcomes?Yes
Risk A: Composite variable of fatal or nonfatal stroke, hospitalization due to stroke, or death from any cause
Are there secondary outcomes?Yes
Risk A: Every single event of the composite outcome
13. Study design
What is the design of the study?
Cohort study
Drug utilisation study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
Based on the longitudinal data in the database, patients will be followed until their death, being transferred out of SIDIAP's administrative area, or the end of study period.
15. Data analysis plan
Please provide a brief summary of the analysis method
Drug U: Demographic, diagnostic and pharmacoepidemiologic data will be analysed using descriptive statistics. Prevalence of antidepressant use will be described for all the study period (2009-2015), and for each year stratified by age group, sex, and indication of prescription. Variables will be reported as mean ± standard deviation, median or as frequency and percentage, as appropriate.
Risk A: The cohorts will be formed by matching on the propensity score (PS) of their baseline characteristics. PS will be calculated by logistic regression of antidepressant use. Crude incidence rates, rate ratios and adjusted incidence rates and rate ratios will be reported for the composite outcome. For reporting adjusted incidence rates, calculated by Poisson regression will be used. The hazard ratio for the risk of composite outcome will be calculated. An analysis of marginal structural models for co-morbidity and other confounding variables, whose exposure varies over time, will be applied.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
Available when the study ends
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Conflict(s) of interest of
investigator(s)Not submitted
Composition of Steering Group and
ObserversNot submitted
Other documents
DescriptionDocumentLatest version
Signed Code of
Conduct Checklist
Not submitted
Signed Code of Conduct Declaration
Not submitted
Signed Checklist for Study
Protocols
Not submitted
