Journal article
Inadequate follow-up care for depression and its impact on antidepressant treatment duration among veterans with and without diabetes mellitus in the Veterans Health Administration
General hospital psychiatry, Vol.28(6), pp.465-474
2006
DOI: 10.1016/j.genhosppsych.2006.08.002
PMID: 17088161
Abstract
Our objective was to describe the adequacy of follow-up care for depression and its association with antidepressant treatment duration among veterans with and without diabetes mellitus (DM).
This was a retrospective study (1997–2005) of 2178 veterans (33% with DM) in a Midwestern Veterans Health Administration facility who had a new episode of unipolar depression. Adequate follow-up care was defined by a health care visit within 7 and 14 days, and ≥3 visits following antidepressant treatment initiation. Adequate treatment duration was defined by a medication possession ratio of ≥80%. Multivariate logistic regression was used to calculate odds ratios (ORs) adjusted for demographic, clinical and health care utilization characteristics.
Only 27% received ≥3 follow-up visits within 12 weeks, and <23% received follow-up within 2 weeks of antidepressant initiation. Subjects with DM were 1.36-fold more likely [95% confidence interval (95% CI)=1.05–1.75] to have received ≥3 visits but were similarly likely to have received follow-up within 7 days (OR=1.02; 95% CI=0.74–1.41) or 14 days (OR=1.08; 95% CI=0.83–1.40) of antidepressant initiation. Adequate follow-up care was the most important predictor of adequate treatment duration (OR=2.10; 95% CI=1.54–2.88).
DM had little influence on the adequacy of follow-up care for depression, with few exceptions. Follow-up care for depression is underutilized and has a significant impact on antidepressant treatment duration. Strategies to more effectively manage depression treatment are required.
Details
- Title: Subtitle
- Inadequate follow-up care for depression and its impact on antidepressant treatment duration among veterans with and without diabetes mellitus in the Veterans Health Administration
- Creators
- Laura E Jones - Roudebush VAMC HSR&D Center of Excellence on Implementing Evidence-Based Practice (CIEBP), Indianapolis, IN 46202, USACarolyn Turvey - Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52246, USACaroline Carney-Doebbeling - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52246, USA
- Resource Type
- Journal article
- Publication Details
- General hospital psychiatry, Vol.28(6), pp.465-474
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.genhosppsych.2006.08.002
- PMID
- 17088161
- ISSN
- 0163-8343
- eISSN
- 1873-7714
- Language
- English
- Date published
- 2006
- Academic Unit
- Psychiatry; Epidemiology
- Record Identifier
- 9984004086502771
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