The stratified medicalisation of mental health symptoms: educational inequalities in the use of psychotropic medication in Belgium.
Educational inequalities
Health care use
Health care use inequalities
Medicalisation
Psychotropic medication use
Journal
Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
04
10
2021
accepted:
31
03
2022
medline:
14
4
2023
pubmed:
16
4
2022
entrez:
15
4
2022
Statut:
ppublish
Résumé
Several studies have shown socioeconomic inequalities in psychotropic medication use, but most of these studies are inspired by Andersen's behavioural model of health care use, which strongly focusses on individuals' needs. Andersen's model pays little attention to health care use that is not based on need and insubstantially recognises the context dependentness of individuals. Medicalisation, however, is a context-dependent interactive process that not only interacts with need determinants, but also with non-need determinants that affect health care use. Therefore, this study will examine if psychotropic medication use is stratified, and whether this is not simply the result of differences in need for care, but also influenced by factors not based on need, initiating the stratified medicalisation of mental health symptoms. Data from the Belgian Health Interview Survey (BHIS) are used. This study covers information from five successive waves: 2001, 2004, 2013, 2018. The weighted data represent a sample of the adult Belgian population. The research aims are analysed using stepwise Poisson regression models, where the models are also plotted to detect evolutions over time, using marginal means postestimation. The results reveal that educational inequalities in psychotropic medication use are significant and persistently visible over time. Even after entering need for care, educational inequalities remain significant. This study shows that psychotropic medication use is stratified and that this is not simply the result of differences in need for care, but also influenced by factors linked to the stratified medicalisation of mental health symptoms.
Identifiants
pubmed: 35426506
doi: 10.1007/s00127-022-02283-1
pii: 10.1007/s00127-022-02283-1
doi:
Substances chimiques
Psychotropic Drugs
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
833-842Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
Références
Chiappini S, Schifano F, Martinotti G (2021) Prescribing psychotropics: misuse, abuse, dependence. Withdrawal Addict Front Psychiatry 12:597
Estrela M, Herdeiro MT, Ferreira PL, Roque F (2020) The use of antidepressants, anxiolytics, sedatives and hypnotics in Europe: focusing on mental health care in Portugal and prescribing in older patients. Int J Environ Res Public Health 17(22):8612
doi: 10.3390/ijerph17228612
pubmed: 33228203
pmcid: 7699589
Gisle L, Drieskens S, Demarest S, Van der Heyden J (2020) Mental health: Health Interview Survey 2018. Sciensano
Federal Planning Bureau (FPB) (2021) Good health and well-being: reimbursed psychotropic medication. Retrieved from https://indicators.be/en/i/G03_RPM/Reimbursed_psychotropic_medication
Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? Journal of health and social behavior:1–10
Lorant V, Boland B, Humblet P, Deliège D (2002) Equity in prevention and health care. J Epidemiol Community Health 56(7):510–516
doi: 10.1136/jech.56.7.510
pubmed: 12080158
pmcid: 1732200
Hanratty B, Zhang T, Whitehead M (2007) How close have universal health systems come to achieving equity in use of curative services? A systematic review. Int J Health Serv 37(1):89–109
doi: 10.2190/TTX2-3572-UL81-62W7
pubmed: 17436987
Morris S, Sutton M, Gravelle H (2005) Inequity and inequality in the use of health care in England: an empirical investigation. Soc Sci Med 60(6):1251–1266
doi: 10.1016/j.socscimed.2004.07.016
pubmed: 15626522
Mechanic D, McAlpine DD (2010) Sociology of health care reform: building on research and analysis to improve health care. J Health Soc Behavior 51 (1_suppl):S147–S159
Missinne S (2015) Moving towards a better understanding of socioeconomic inequalities in preventive health care use: a life course perspective. A life course perspective on health trajectories and transitions 111–131
Cockerham WC (2005) Health lifestyle theory and the convergence of agency and structure. J Health Soc Behav 46(1):51–67
doi: 10.1177/002214650504600105
pubmed: 15869120
Cockerham WC (2007) The social causes of health and disease. Policy Press, Cambridge
Conrad P (1992) Medicalization and social control. Ann Rev Sociol 18(1):209–232
doi: 10.1146/annurev.so.18.080192.001233
Conrad P (2005) The shifting engines of medicalization. J Health Soc Behav 46(1):3–14
doi: 10.1177/002214650504600102
pubmed: 15869117
Conrad P, Leiter V (2004) Medicalization, markets and consumers. J Health Soc Behav 158–176
Clarke AE, Shim JK, Mamo L, Fosket JR, Fishman JR (2010) Biomedicalization technoscientific transformations of health, illness, and US biomedicine. Biomedicalization 47–87
Zheng H (2015) Why has medicine expanded? The role of consumers. Soc Sci Res 52:34–46
doi: 10.1016/j.ssresearch.2015.01.006
pubmed: 26004446
Boffin N, Bossuyt N, Declercq T, Vanthomme K, Van Casteren V (2012) Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study. Fam Pract 29(6):678–687
doi: 10.1093/fampra/cms024
pubmed: 22523390
Fraeyman J, Van Hal G, De Loof H, Remmen R, De Meyer G, Beutels P (2012) Potential impact of policy regulation and generic competition on sales of cholesterol lowering medication, antidepressants and acid blocking agents in Belgium. Acta Clin Belgica 67(3):160–171
Butterworth P, Olesen SC, Leach LS (2013) Socioeconomic differences in antidepressant use in the PATH Through Life Study: evidence of health inequalities, prescribing bias, or an effective social safety net? J Affect Disord 149(1–3):75–83
doi: 10.1016/j.jad.2013.01.006
pubmed: 23394713
Comino EJ, Harris E, Silove D, Manicavasagar V, Harris MF (2000) Prevalence, detection and management of anxiety and depressive symptoms in unemployed patients attending general practitioners. Aust N Z J Psychiatry 34(1):107–113
doi: 10.1046/j.1440-1614.2000.00645.x
pubmed: 11185922
Rijksinstituut voor ziekte- en invalideitsverzekering (RIZIV) (2021) Start van een toegankelijker psychologisch zorgmodel met geleidelijke uitrol in het hele land [Start of a more accessible psychological care model with gradual roll-out across the country]. Retrieved from https://www.riziv.fgov.be/nl/nieuws/Paginas/versterkt-psychologisch-zorgaanbod-voor-iedereen-september.aspx
Johnson CF, Williams B, MacGillivray SA, Dougall NJ, Maxwell M (2017) ‘Doing the right thing’: factors influencing GP prescribing of antidepressants and prescribed doses. BMC Fam Pract 18(1):1–13
doi: 10.1186/s12875-017-0643-z
Shavers VL (2007) Measurement of socioeconomic status in health disparities research. J Natl Med Assoc 99(9):1013
pubmed: 17913111
pmcid: 2575866
Psacharopoulos G, Patrinos HA (2018) Returns to investment in education: a decennial review of the global literature. Educ Econ 26(5):445–458
doi: 10.1080/09645292.2018.1484426
Goldberg D, Williams P (2000) General health questionnaire (GHQ). NferNelson, Swindon, Wiltshire, UK
del Pilar S-López M, Dresch V (2008) The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema 20(4):839–843
Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69(3):307–316
doi: 10.1016/j.socscimed.2009.05.013
pubmed: 19520474
Halford C, Wallman T, Welin L, Rosengren A, Bardel A, Johansson S, Eriksson H, Palmer E, Wilhelmsen L, Svärdsudd K (2012) Effects of self-rated health on sick leave, disability pension, hospital admissions and mortality. A population-based longitudinal study of nearly 15,000 observations among Swedish women and men. BMC Public Health 12(1):1–11
Pu C, Bai YM, Chou YJ (2013) The impact of self-rated health on medical care utilization for older people with depressive symptoms. Int J Geriatr Psychiatry 28(5):479–486
doi: 10.1002/gps.3849
pubmed: 22700167
Wauters M, Elseviers M, Peeters L, De Meester D, Christiaens T, Petrovic M (2019) Reducing psychotropic drug use in nursing homes in Belgium: an implementation study for the roll-out of a practice improvement initiative. Drugs Aging 36(8):769–780
doi: 10.1007/s40266-019-00686-5
pubmed: 31209735
Lindsey PL (2009) Psychotropic medication use among older adults: what all nurses need to know. J Gerontol Nurs 35(9):28–38
doi: 10.3928/00989134-20090731-01
pubmed: 19715261
pmcid: 3128509
Ćurković M, Dodig-Ćurković K, Petek Erić A, Kralik K, Pivac N (2016) Psychotropic medications in older adults: a review. Psychiatria Danubina 28(1):24
Téllez-Lapeira J, López-Torres Hidalgo J, García-Agua Soler N, Gálvez-Alcaraz L, Escobar-Rabadán F, García-Ruiz A (2016) Prevalence of psychotropic medication use and associated factors in the elderly. Eur J Psychiatry 30(3):183–194
Popelier K, Peeters L (2018) Psychofarmaca in woonzorgcentra. Samen op weg naar minder [Psychotropic medication in residential care. Together on the road to less]. Retrieved from https://www.vad.be/assets/vad026_a4_psychofarmaca_in_woonzorgcentra
Belgian Psychotropics Experts Platform (BelPEP) (2014) Globale visienota en actieplan van de drie werkgroepen [Global vision statement and action plan of the three working groups]. Retrieved from https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/visienota_nl_april_2015.pdf
Belgian Health Care Knowledge Center (KCE) (2019) Organisation of mental health care for adults in Belgium. Retrieved from https://kce.fgov.be/sites/default/files/atoms/files/KCE_318_Mental_Health_care_Report_0.pdf
Ohayon MM, Lader MH (2002) Use of psychotropic medication in the general population of France, Germany, Italy, and the United Kingdom. J Clin Psychiatry 63(9)
Hansen DG, Søndergaard J, Vach W, Gram LF, Rosholm J-U, Kragstrup J (2003) Antidepressant drug use in general practice: inter-practice variation and association with practice characteristics. Eur J Clin Pharmacol 59(2):143–149
doi: 10.1007/s00228-003-0593-3
pubmed: 12721774
Mercier A, Benichou J, Auger-Aubin I, Lebeau J-P, Houivet E, Van Royen P, Peremans L (2015) How do GP practices and patient characteristics influence the prescription of antidepressants? A cross-sectional study. Ann Gen Psychiatry 14(1):1–10
doi: 10.1186/s12991-015-0041-7
Anthierens S, Habraken H, Petrovic M, Christiaens T (2007) The lesser evil? Initiating a benzodiazepine prescription in general practice: a qualitative study on GPs’ perspectives. Scand J Prim Health Care 25(4):214–219
doi: 10.1080/02813430701726335
pubmed: 18041658
pmcid: 3379762
Anrys PM, Strauven GC, Foulon V, Degryse J-M, Henrard S, Spinewine A (2018) Potentially inappropriate prescribing in Belgian nursing homes: prevalence and associated factors. J Am Med Dir Assoc 19(10):884–890
doi: 10.1016/j.jamda.2018.06.010
pubmed: 30056012
Mayeur T (2017) Wie teveel voorschrijft krijgt boete van De Block (Minister van Volksgezondheid) [Anyone who prescribes too much will be fined by De Block (Minister of Health)]. Retrieved from https://www.knack.be/nieuws/gezondheid/artsen-die-te-veel-voorschrijven-strenger-bestraft/article-normal-74368.html?msclkid=bff3f323bb4511ecb9324e1bbd43bdbc
Buffel V, Beckfield J, Bracke P (2017) The institutional foundations of medicalization: a cross-national analysis of mental health and unemployment. J Health Soc Behav 58(3):272–290
doi: 10.1177/0022146517716232
pubmed: 29164950
Goldberg JF, Ernst CL (2018) Managing the side effects of psychotropic medications. American Psychiatric Association Publishing, Washington D.C.
Cummings NA, Wiggins JG (2016) a collaborative primary care/behavioral healthcare model for the use of psychotropic medication with children and adolescents: the report of a national retrospective study. In: Psyche's Prophet. Routledge, pp 103–115