The association between antidepressant dosage titration and medication adherence among patients with depression

Depression and Anxiety
Chung-Hsuen WuBradley N Gaynes

Abstract

To evaluate the association between upward dose titration of antidepressants and medication adherence during the first 6 months of a newly initiated antidepressant treatment for patients with major depressive disorder (MDD). We conducted a retrospective observational cohort study using Thomson Reuters MarketScan Commercial Claims and Encounters Claims data. We identified 40,873 patients aged 18-64 with MDD newly initiating a selective serotonin reuptake inhibitor, serotonin-norepinephrine reuptake inhibitor, or bupropion between July 1, 2005 and June 30, 2007. Patients with titration (defined as antidepressant initiation at doses equal or lesser than American Psychiatric Association treatment guidelines with a dosage increase in the first 60 days of treatment) were compared to patients with no titration. Adherence was measured as the proportion of days covered (PDC) on antidepressant treatment. Patients with PDC ≥ 80% were considered adherent. Persistence was measured as the duration of time from initiation to a 30-day gap in antidepressant treatment. Multivariate logistic regression and Cox-proportional hazard models examined the influence of titration on adherence and persistence, respectively. Adherence was greater in the ti...Continue Reading

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Citations

Mar 5, 2016·International Journal of Clinical Pharmacy·Amany K HassanBarbara R Neas
Apr 23, 2013·Acta Psychiatrica Scandinavica. Supplementum·G S MalhiK Fritz
Nov 28, 2014·Journal of Clinical Pharmacology·Franco LapiSamy Suissa
Dec 30, 2014·Journal of Affective Disorders·Koen DemyttenaereKees van Heeringen
Jul 18, 2014·Current Opinion in Psychiatry·Ching-I Hung

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