Guideline-concordant antidepressant use among patients with major depressive disorder

General Hospital Psychiatry
Shih-Yin ChenMatthew L Maciejewski

Abstract

To examine whether prescriber specialty and guideline-concordant follow-up visits were associated with antidepressant treatment completion among patients with major depressive disorder (MDD). 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 > or =3 visits during the treatment phase. Completion of acute phase (first 90 days) and continuation phase (Days 91-270) was defined by adherence > or = 80% without significant gaps in treatment. Logistic regressions were used to examine factors associated with treatment completion. 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<.0001) to complete acute phase than patients without guideline-concordant follow-ups. Receipt of guideline-concordant follow-ups increased the probability of acute phase completion by an additional 6.8 percentage points if initially treated by psychiatrists. Patien...Continue Reading

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