TY - JOUR

T1 - Work-unit organisational changes and subsequent prescriptions for psychotropic medication

T2 - a longitudinal study among public healthcare employees

AU - Jensen, Johan Høy

AU - Bonde, Jens Peter

AU - Flachs, Esben Meulengracht

AU - Skakon, Janne

AU - Rod, Naja Hulvej

AU - Kawachi, Ichiro

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019

Y1 - 2019

N2 - OBJECTIVES: We examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees.METHODS: The study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region of Denmark. Multilevel mixed-effects parametric survival models were developed to examine time to prescription for psychotropic medications (anxiolytics/hypnotics/sedatives/antidepressants) during the 12-month interval following exposure to organisational changes relative to no change from January to December 2013. Data on work-unit level organisational changes (including mergers, split-ups, relocation, change in management, employee lay-offs and budget cuts) were collected from work-unit managers (59% response).RESULTS: Any organisational change versus no change was associated with a higher risk of psychotropic prescription (HR: 1.14, 95% CI: 1.02 to 1.26), especially change in management (HR: 1.23, 95% CI: 1.07 to 1.41). Splitting the 12-month follow-up period into two halves yielded particularly high rates of psychotropic prescription in the latter half of the follow-up, for example, any change (HR: 1.25, 95% CI: 1.11 to 1.41), change in management (HR: 1.42, 95% CI: 1.22 to 1.65), mergers (HR: 1.26, 95% CI: 1.06 to 1.50), employee lay-off (HR: 1.23, 95% CI: 1.03 to 1.46) and budget cuts (HR: 1.13, 95% CI: 1.00 to 1.41). The associations did not vary by sex.CONCLUSIONS: Organisational changes in the workplace, especially change in management, may be associated with increased risk of psychotropic prescription among employees regardless of sex.

AB - OBJECTIVES: We examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees.METHODS: The study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region of Denmark. Multilevel mixed-effects parametric survival models were developed to examine time to prescription for psychotropic medications (anxiolytics/hypnotics/sedatives/antidepressants) during the 12-month interval following exposure to organisational changes relative to no change from January to December 2013. Data on work-unit level organisational changes (including mergers, split-ups, relocation, change in management, employee lay-offs and budget cuts) were collected from work-unit managers (59% response).RESULTS: Any organisational change versus no change was associated with a higher risk of psychotropic prescription (HR: 1.14, 95% CI: 1.02 to 1.26), especially change in management (HR: 1.23, 95% CI: 1.07 to 1.41). Splitting the 12-month follow-up period into two halves yielded particularly high rates of psychotropic prescription in the latter half of the follow-up, for example, any change (HR: 1.25, 95% CI: 1.11 to 1.41), change in management (HR: 1.42, 95% CI: 1.22 to 1.65), mergers (HR: 1.26, 95% CI: 1.06 to 1.50), employee lay-off (HR: 1.23, 95% CI: 1.03 to 1.46) and budget cuts (HR: 1.13, 95% CI: 1.00 to 1.41). The associations did not vary by sex.CONCLUSIONS: Organisational changes in the workplace, especially change in management, may be associated with increased risk of psychotropic prescription among employees regardless of sex.

U2 - 10.1136/oemed-2018-105442

DO - 10.1136/oemed-2018-105442

M3 - Journal article

C2 - 30617127

VL - 76

SP - 143

EP - 150

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

IS - 3

ER -