Anxiety is a common problem in the UK. Between 1998 and 2008, GP recording of anxiety symptoms increased, whilst GP recording of anxiety disorders decreased. No data has been published since 2008. Therefore, our first aim is to examine recent data on GP recording of anxiety to see whether this trend has continued.
GPs may prescribe medication to help patients with their symptoms. Antidepressants are recommended for anxiety, although other drugs, such as benzodiazepines, may be used. The number of antidepressant prescriptions for depression have increased in the last two decades, but we do not know if antidepressant prescriptions for anxiety have increased.
Benzodiazepines may be prescribed for other things, such as sleep problems. The total number of benzodiazepine prescriptions stayed the same between 2008 and 2012. However, use of these drugs for sleep problems is decreasing, which may mean that the number of prescriptions for anxiety is increasing. However, no data for benzodiazepine use, or any of the other drugs used for anxiety, has been published since 2012. Therefore, our second aim is to examine trends in prescribing for anxiety in primary care.
This study will investigate trends in anxiety symptoms and diagnoses, and trends in prescribing for anxiety, in the UK between 2003 and 2018, and examine associated factors. The study will use a retrospective cohort design, including patients aged 18 or over in CPRD who have an anxiety code between 1st January 2003 and 31st December 2018. The number of patients with a new episode defined by a symptom code or a diagnosis code in each calendar year will be calculated. In addition, the number of patients who received at least one prescription for anxiolytic medication, and the number of patients who started such medication in each calendar year will be calculated. Person-years at risk will be used as the denominator. Incidence rates and 95%CI will be calculated using Poisson regression. Data will be plotted to examine patterns of prescribing over time for all medications combined, and separately by drug class (antidepressants, benzodiazepines, anticonvulsants, antipsychotics, beta blockers). Changes in trends over time will be examined using join point regression. Data will be stratified by age/sex. We will also calculate the average treatment duration for incident cases to examine whether there have been changes in long-term prescribing.
This project will explore trends in anxiety diagnoses and symptoms over time, and trends in medication prescribed for anxiety (antidepressants [SSRIs, SNRIs, TCAs, MAOIs], benzodiazepines, anticonvulsants [pregabalin, gabapentine], antipsychotics [quetiapine], beta blockers [propranol]), in the UK between 2003 and 2018.
Nicola Wiles - Chief Investigator - University of Bristol
Charlotte Archer - Corresponding Applicant - University of Bristol
Becky Mars - Collaborator - University of Bristol
David Kessler - Collaborator - University of Bristol
Katrina Turner - Collaborator - University of Bristol