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Försäljning och förskrivning av antidepressiva läkemedel ur genusperspektiv.
Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
2017 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Inledning: I Sverige såväl som i många andra länder konsumerar kvinnor mer sjukvård och läkemedel än män. Till viss del kan skillnaden förklaras av sjukdomspanoramat och förskrivningen av p-piller. För depressioner och GAD kan biologiska och sociologiska faktorer påverka. Även genusbias, det vill säga snedvridning eller fördomar i förhållande till genus eller kön, förmodas spela en viss roll. Prevalensen av depression hos vuxna är ca 5–8 % och ökar bland äldre till ca13 %. Livstidsrisken att drabbas av GAD är ca 8 % och ettårsprevalensen är 1,6–3,1 %. Syftet med detta examensarbete är att ur ett genusperspektiv undersöka försäljning och förskrivning av antidepressiva läkemedel. Vem förskriver dem? Finns det preferenser mellan preparaten, eller geografiska, åldersmässiga eller ekonomiska skillnader i förskrivning mellan könen. Material och metod: Uppgifter har erhållits från Socialstyrelsens statistikdatabas och Läkemedelsenheten inom Region Kronoberg. Resultat: År 2015 köpte drygt 900 000 personer antidepressiva läkemedel i Sverige. I Kronobergs län var det 18 700 fördelat på 12,9 % till kvinnor och 6,8 % till män. Försäljningen till kvinnor ökar relativt sett mer än männens fram till klimakteriet för att sedan jämnas ut. Närmare 40 % av kvinnorna och var fjärde man köper ut antidepressiva läkemedel i de högsta åldrarna. Räknat i DDD förskrivs till kvinnor i Kronobergs län 1,87 gånger större volymer antidepressiva än till män. 70 % förskrevs från vårdcentraler, 14 % inom psykiatrin och resten från fr.a. sjukhusläkare. En mindre geografisk skillnad ses mellan länen (+/- 5 %). Sertralin (29 %) och citalopram (19 %) står för ca hälften av volymen. Inom primärvården behandlas relativt sett (65 %) mer kvinnor än inom den psykiatriska vården (59 %). Det ses ingen skillnad i kostnad (AUP) per DDD mellan könen.

 Slutsats: Ca 10 % av Sveriges befolkning köpte år 2015 ett antidepressivt läkemedel. Till kvinnor försäljs/förskrivs dubbelt så mycket antidepressiva läkemedel än till män. Det finns inget entydigt svar på varför denna skillnad ses. Det kan vara en överbehandling hos kvinnor eller en underbehandling av män.

Abstract [en]

In Sweden as well as in other countries women are consuming more health care and medicinal drugs than men. Partly, this difference can be explained by disease panorama and prescription of contraceptive pills. Biological and sociological factors may have an influence in cases of depression and GAD. Also, gender bias, a twisted view and prejudice concerning gender or sex, is thought to play a part. Among adults the depression prevalence rate ranges from 5% to 8%, and it increases to around 13% among elderly people. The lifetime risk of being effected by GAD is around 8% and the one-year prevalence rate ranges from 1.6% to 3.1%.

The purpose of this study is to examine the sale/prescription of antidepressants from a gender perspective. Who prescribes the drugs? Are some drugs preferred to others, and are there geographical, age-related or economical differences between the sexes regarding prescriptions of antidepressants?

Information about the type and the extent of the sale of antidepressants has been obtained from The National Board of Health and Welfare and The Medicine Unit (Läkemedelsenheten) in Kronoberg County.

In 2015 more then 900.000 people bought antidepressants in Sweden. In Kronoberg (G County) 18.700 people bought antidepressants, 12.9% of them were women and 6.8% men. The sale in G County is slightly higher than in the rest of the country. The purchase among women increases relatively more than among men until menopause, after which the difference in purchase is stabilized. Almost 40% of the women and one of every four men purchase antidepressants in the highest ages. Counting in terms of DDD, women in G County are buying 1.87 times bigger volumes of antidepressants than men, of which 70% are prescribed at health centers, 14% in the mental health care area and the rest mainly by doctors working at hospitals. A small geographical difference can be seen between the counties in Sweden (+/- 5%). Within each county the prescription difference between men and women is small. Two drugs, sertraline (29%) and citalopram (19%), make up about half the volume. In the mental health care area slightly larger volumes of venlafaxine and duloxetine are prescribed to women compared to men. Men are prescribed somewhat more of fluoxetin. Relatively more women (65%) are treated for depression in primary care than in psychiatric care (59%). In primary care, women are prescribed relatively more Duloxetine. No difference in cost (pharmacy sales price (PSP)) per DDD can be observed between the sexes.

Conclusion: Approx. 10% of the Swedish population bought antidepressants in 2015. Two times more women than men are purchase antidepressants. There is no definite answer to what is causing this difference. Can it be caused by overconsumption among women, or inadequate treatment among men? The greater part of antidepressants is prescribed in out-patient care, which indicates that antidepressants are used mainly in cases of less noticeable anxiety symptoms and mild to moderate depression. According to The Swedish Board of Health and Welfare these cases should foremost be treated with CBT.

Place, publisher, year, edition, pages
2017. , p. 30
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-63820OAI: oai:DiVA.org:lnu-63820DiVA, id: diva2:1095435
Subject / course
Pharmacy
Educational program
Bachelor of Science Programme in Pharmacy, 180 credits
Supervisors
Examiners
Available from: 2017-05-15 Created: 2017-05-14 Last updated: 2017-05-15Bibliographically approved

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