Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees

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Johan Høy Jensen, Jens Peter Bonde, Esben Meulengracht Flachs, Janne Skakon, Naja Hulvej Rod, Ichiro Kawachi

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.

Original languageEnglish
JournalOccupational and Environmental Medicine
Issue number3
Pages (from-to)143-150
Number of pages8
Publication statusPublished - 2019

ID: 216914205