The influence of general practitioner and patient sex on the treatment of major depression

Biological and sociocultural factors may lead to a significant gender bias in the treatment of major depression and thus contribute to accentuating gender inequalities. However, the influence of the general practitioner's (GP's) sex on the prescription of antidepressants has not been adequ...

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Autores: Jufresa-Blanch, Elisabeth, Carrilero, Neus|||0000-0002-2084-0803, García-Altés, Anna|||0000-0003-3889-5375
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:296602
Acceso en línea:https://ddd.uab.cat/record/296602
https://dx.doi.org/urn:doi:10.3389/fphar.2023.1274774
Access Level:acceso abierto
Palabra clave:Antidepressive agents
General practitioners
Major depressive disorder
Primary healthcare
Sexism
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spelling The influence of general practitioner and patient sex on the treatment of major depressionJufresa-Blanch, ElisabethCarrilero, Neus|||0000-0002-2084-0803García-Altés, Anna|||0000-0003-3889-5375Antidepressive agentsGeneral practitionersMajor depressive disorderPrimary healthcareSexismBiological and sociocultural factors may lead to a significant gender bias in the treatment of major depression and thus contribute to accentuating gender inequalities. However, the influence of the general practitioner's (GP's) sex on the prescription of antidepressants has not been adequately assessed in previous work and remains unclear. This retrospective cohort study aims to determine the influence of GP and patient sex on the treatment of major depression. The study population comprised 87,629 patients (33.56% male patients and 66.44% female patients) aged over 15 years newly diagnosed with major depression recorded between 2017 and 2019 in Catalonia, Spain. Logistic regression models were used to evaluate the effect of GP sex on the therapeutic strategy (i.e., whether antidepressants were prescribed at the first diagnostic visit). Cox proportional hazards models and survival analyses were conducted to compare, according to GP and patient sex, the probability that a patient would be prescribed an antidepressant at any time during the study period. Finally, a multiple linear regression analysis was performed to assess the pharmacological intensity of the treatment [monthly fluoxetine-equivalent defined daily dose (DDD)]. Female patients were more likely to be prescribed an antidepressant at the time of diagnosis, both by male [OR = 1.11, 95% CI = (1.05, 1.17), p (Formula presented.) 0.001] and female GPs [OR = 1.13, 95% CI = (1.09, 1.17), p (Formula presented.) 0.001]. Similarly, female patients were 8% and 9% more likely than male patients to be prescribed an antidepressant from male [HR = 1.08, 95% CI = (1.05, 1.11), p (Formula presented.) 0.001] and female GPs [HR = 1.09, 95% CI = (0.92, 1.07), p (Formula presented.) 0.001], respectively, during the study period. Female GPs prescribed less antidepressants than male GPs: an average of 0.39 less monthly fluoxetine-equivalent DDD [β = -0.39, 95% CI = (0.10, -3.92), p (Formula presented.) 0.001]. Few differences are observed between male and female GPs regarding the therapeutic strategy and its intensity for the treatment of major depression. However, both male and female GPs are influenced by biases and stereotypes that entail differential antidepressant-prescribing behaviors in accordance with the sex of the patient and their characteristics.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/296602https://dx.doi.org/urn:doi:10.3389/fphar.2023.1274774reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2966022026-06-06T12:50:31Z
dc.title.none.fl_str_mv The influence of general practitioner and patient sex on the treatment of major depression
title The influence of general practitioner and patient sex on the treatment of major depression
spellingShingle The influence of general practitioner and patient sex on the treatment of major depression
Jufresa-Blanch, Elisabeth
Antidepressive agents
General practitioners
Major depressive disorder
Primary healthcare
Sexism
title_short The influence of general practitioner and patient sex on the treatment of major depression
title_full The influence of general practitioner and patient sex on the treatment of major depression
title_fullStr The influence of general practitioner and patient sex on the treatment of major depression
title_full_unstemmed The influence of general practitioner and patient sex on the treatment of major depression
title_sort The influence of general practitioner and patient sex on the treatment of major depression
dc.creator.none.fl_str_mv Jufresa-Blanch, Elisabeth
Carrilero, Neus|||0000-0002-2084-0803
García-Altés, Anna|||0000-0003-3889-5375
author Jufresa-Blanch, Elisabeth
author_facet Jufresa-Blanch, Elisabeth
Carrilero, Neus|||0000-0002-2084-0803
García-Altés, Anna|||0000-0003-3889-5375
author_role author
author2 Carrilero, Neus|||0000-0002-2084-0803
García-Altés, Anna|||0000-0003-3889-5375
author2_role author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Antidepressive agents
General practitioners
Major depressive disorder
Primary healthcare
Sexism
topic Antidepressive agents
General practitioners
Major depressive disorder
Primary healthcare
Sexism
description Biological and sociocultural factors may lead to a significant gender bias in the treatment of major depression and thus contribute to accentuating gender inequalities. However, the influence of the general practitioner's (GP's) sex on the prescription of antidepressants has not been adequately assessed in previous work and remains unclear. This retrospective cohort study aims to determine the influence of GP and patient sex on the treatment of major depression. The study population comprised 87,629 patients (33.56% male patients and 66.44% female patients) aged over 15 years newly diagnosed with major depression recorded between 2017 and 2019 in Catalonia, Spain. Logistic regression models were used to evaluate the effect of GP sex on the therapeutic strategy (i.e., whether antidepressants were prescribed at the first diagnostic visit). Cox proportional hazards models and survival analyses were conducted to compare, according to GP and patient sex, the probability that a patient would be prescribed an antidepressant at any time during the study period. Finally, a multiple linear regression analysis was performed to assess the pharmacological intensity of the treatment [monthly fluoxetine-equivalent defined daily dose (DDD)]. Female patients were more likely to be prescribed an antidepressant at the time of diagnosis, both by male [OR = 1.11, 95% CI = (1.05, 1.17), p (Formula presented.) 0.001] and female GPs [OR = 1.13, 95% CI = (1.09, 1.17), p (Formula presented.) 0.001]. Similarly, female patients were 8% and 9% more likely than male patients to be prescribed an antidepressant from male [HR = 1.08, 95% CI = (1.05, 1.11), p (Formula presented.) 0.001] and female GPs [HR = 1.09, 95% CI = (0.92, 1.07), p (Formula presented.) 0.001], respectively, during the study period. Female GPs prescribed less antidepressants than male GPs: an average of 0.39 less monthly fluoxetine-equivalent DDD [β = -0.39, 95% CI = (0.10, -3.92), p (Formula presented.) 0.001]. Few differences are observed between male and female GPs regarding the therapeutic strategy and its intensity for the treatment of major depression. However, both male and female GPs are influenced by biases and stereotypes that entail differential antidepressant-prescribing behaviors in accordance with the sex of the patient and their characteristics.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/296602
https://dx.doi.org/urn:doi:10.3389/fphar.2023.1274774
url https://ddd.uab.cat/record/296602
https://dx.doi.org/urn:doi:10.3389/fphar.2023.1274774
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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