Status: Ongoing
First registered on:
24/05/2019
Last updated on:
29/08/2020
1. Study identification
EU PAS Register NumberEUPAS29862
Official titleInfluence of social deprivation on psychotropic drugs dispensing in adults: a large cross-sectional population-based study in France
Study title acronymISDepPSY
Study typeObservational study
Brief description of the studyIntroduction: Links between lower socioeconomic position (SEP) and prevalence of common mental health disorders (CMHD) have been identified in the literature, and adequacy of treatments seems to differ according to SEP.
We assume that lower SEP is associated with more psychotropic drugs consumption and more inadequate use.
Primary objective: to assess correlation between the number of dispensing of anxiolytic and hypnotic drugs and social deprivation (EDI).
Methods: Retrospective cross-sectional population-based study. Based on the joint use of French healthcare insurance population-based data on reimbursement of out-of-hospital care during the year 2012, which included 2,574,310 individuals and an ecological indicator of social deprivation in the Midi-Pyrénées region of France.
Main outcomes and data of interest:
- Number of distinct anxiolytic and hypnotic drugs (ATC: N05) dispensing.
- Number of distinct antidepressant drugs (ATC: N06A) dispensing.
- Adequacy with guidelines regarding psychotropic drug dispensing patterns among patients being dispensed at least one psychotropic drug, defined as:
. Six or more distinct dispensing dates of antidepressant drugs (ATC: N06A), if any antidepressant drugs dispensing
AND
. Three or less distinct dispensing dates of anxiolytic drugs (ATC: N05BA)
AND
. Two or less distinct dispensing dates of hypnotic drugs (ATC: N05CD and N05CF)
- European Deprivation Index (EDI): a validated ecological deprivation index that approaches SEP
Statistical analysis: Univariate analyses (linear regression) and then multivariate analysis of the association between the number of anxiolytic and hypnotic drugs dispensed and EDI (primary objective), then other covariates and EDI (secondary objectives), will be performed to obtain correlation coefficients. If the assumptions for linear regression are not met, logistic regression will be performed to obtain Odds Ratios.
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
Department/Research groupPharmacoepidemiology research team
Organisation/affiliationUniversity of Toulouse 3 and INSERM 1027
Details of (Primary) lead investigator
Title Professor
Last name Rougé-Bugat
First name Marie-Eve
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
France
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed10/12/2018
Start date of data collection01/11/201901/11/2019
Start date of data analysis01/11/201901/12/2019
Date of interim report, if expected
Date of final study report15/09/2020
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 body
Research councils
EU funding scheme
Otherself-funding100
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Rougé-Bugat
First name Marie-Eve
Address line 137 Allees Jules Guesde
Address line 2
Address line 3
CityToulouse
Postcode31000
CountryFrance
Phone number (incl. country code)33-562889048
Alternative phone number33-561145606
Fax number (incl. country code)33-562889084
Public Enquiries
Title Professor
Last name Rougé-Bugat
First name Marie-Eve
Address line 137 Allees Jules Guesde
Address line 2
Address line 3
CityToulouse
Postcode31000
CountryFrance
Phone number (incl. country code)33-562889048
Alternative phone number33-561145606
Fax number (incl. country code)33-562889084
6. Study drug(s) information
Substance class (ATC Code)N05 (PSYCHOLEPTICS)
Substance class (ATC Code)N06A (ANTIDEPRESSANTS)
7. Medical conditions to be studied
Medical condition(s)No
8. Population under study
Age
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects2574310
Additional information
The population sample was built from the French National Healthcare Insurance records in the French region of Midi-Pyrenees, performed prospectively in 2012. The database registered included 2,574,310 individuals, about 87% of the total population of the region (about 5% of the whole French population). We have excluded children under 18 years of age from the primary database.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
AAPRISS, France
Sources of data
Prospective patient-based data collection
11. Scope of the study
What is the scope of the study?
Drug utilisation study
Primary scope : Drug utilisation study
12. Main objective(s)
What is the main objective of the study?
To assess correlation between the number of dispensing of anxiolytic and hypnotic drugs and social deprivation (EDI).
Are there primary outcomes?Yes
Correlation between EDI and number of distinct anxiolytic and hypnotic drugs (ATC: N05) dispensing.
Are there secondary outcomes?Yes
Correlation between EDI and number of distinct antidepressant drugs (ATC: N06A) dispensing.
Correlation between EDI and adequacy with guidelines regarding psychotropic drug dispensing patterns among patients being dispensed at least one psychotropic drug.
13. Study design
What is the design of the study?
Cross-sectional study
14. Follow-up of patients
Will patients be followed up?Not applicable/no follow-up
15. Data analysis plan
Please provide a brief summary of the analysis method
- Descriptive analyses
- Comparative analyses between groups with Chi2 for categorical variables, and Student’s T test or variances analyses.
- p-value <0.05 will be considered as statistically significant
- Univariate analyses (linear regression) of the association between the number of anxiolytic and hypnotic drugs dispensed and EDI (primary objective), then other covariates and EDI (secondary objectives), will be performed to obtain correlation coefficients. If the assumptions for linear regression are not met, logistic regression will be performed to obtain Odds Ratios.
- Then, a multivariate analysis (linear regression, otherwise logistic regression), will be performed. Covariates known to be associated with psychotropic drug misuse in the literature, and those associated in the univariate analysis (p-value < 0.20) will be selected for inclusion in the multivariate model, and secondarily excluded by a backward stepwise procedure.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
Yes
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
1. Surault P. [Mental health and social determinants]. L’Encephale. 2010;36(3 Suppl):27‑32.
2. Murcia M, Chastang J-F, Niedhammer I. Educational inequalities in major depressive and generalized anxiety disorders: results from the French national SIP study. Soc Psychiatry Psychiatr Epidemiol. juin 2015;50(6):919‑28.
3. Ducros D et al. Use of medical and administrative databases to measure social health inequalities, Santé Publique 2015;27(3):383-94.
4. Delpierre C et al. Social inequalities of access to care and prevention in the Midi-Pyrénées region, France, 2012. BEH. 2016;1:2-8.
5. Sjöstedt C, Ohlsson H, Li X, Sundquist K. Socio-demographic factors and long-term use of benzodiazepines in patients with depression, anxiety or insomnia. Psychiatry Res. mars 2017;249:221‑5.
19. Other relevant documents
Other documents
DescriptionDocumentLatest version
Signed Code of
Conduct Checklist
Submitted
Signed Code of Conduct Declaration
Submitted
Signed Checklist for Study
Protocols
Submitted
