Guideline-concordant antidepressant use among patients with major depressive disorder

Abstract Objectives To examine whether prescriber specialty and guideline-concordant follow-up visits were associated with antidepressant treatment completion among patients with major depressive disorder (MDD). Methods This study analyzed medical and prescription claims from a large national health...

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Bibliographic Details
Published in:General hospital psychiatry 2010-07, Vol.32 (4), p.360-367
Main Authors: Chen, Shih-Yin, Ph.D, Hansen, Richard A., Ph.D, Gaynes, Bradley N., M.D., M.P.H, Farley, Joel F., Ph.D, Morrissey, Joseph P., Ph.D, Maciejewski, Matthew L., Ph.D
Format: Article
Language:English
Subjects:
Adult
Antidepressants
Antidepressive Agents, Second-Generation - therapeutic use
Biological and medical sciences
Clinical guideline
Confidence Intervals
Depression
Depressive Disorder, Major - drug therapy
Female
Follow-up visits
Guideline Adherence - statistics & numerical data
Humans
Logistic Models
Male
Medical sciences
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Medicine - statistics & numerical data
Neuropharmacology
Odds Ratio
Office Visits - statistics & numerical data
Pharmacology. Drug treatments
Provider specialty
Psychiatry
Psychiatry - statistics & numerical data
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
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Summary:Abstract Objectives To examine whether prescriber specialty and guideline-concordant follow-up visits were associated with antidepressant treatment completion among patients with major depressive disorder (MDD). Methods This study analyzed medical and prescription claims from a large national health plan. Patients were grouped based on initial prescriber specialty. Receipt of guideline-concordant follow-ups was defined as having ≥3 visits during the treatment phase. Completion of acute phase (first 90 days) and continuation phase (Days 91–270) was defined by adherence ≥80% without significant gaps in treatment. Logistic regressions were used to examine factors associated with treatment completion. Results Forty-seven percent of the 4102 newly diagnosed patients completed the acute phase, 45% of whom also completed the continuation phase. Among those initially prescribed by primary care providers (PCPs), patients with guideline-concordant follow-ups were more likely (13.1 percentage points, P
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2010.03.007