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Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019
BACKGROUND: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. METHODS: Patients with depression were identified from four large national claims databases d...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942399/ https://www.ncbi.nlm.nih.gov/pubmed/31900133 http://dx.doi.org/10.1186/s12888-019-2418-7 |
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author | Kern, David M. Cepeda, M. Soledad Defalco, Frank Etropolski, Mila |
author_facet | Kern, David M. Cepeda, M. Soledad Defalco, Frank Etropolski, Mila |
author_sort | Kern, David M. |
collection | PubMed |
description | BACKGROUND: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. METHODS: Patients with depression were identified from four large national claims databases during 1/1/2014–1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and 3 years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. RESULTS: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29 to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. CONCLUSIONS: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients. |
format | Online Article Text |
id | pubmed-6942399 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69423992020-01-07 Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 Kern, David M. Cepeda, M. Soledad Defalco, Frank Etropolski, Mila BMC Psychiatry Research Article BACKGROUND: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. METHODS: Patients with depression were identified from four large national claims databases during 1/1/2014–1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and 3 years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. RESULTS: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29 to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. CONCLUSIONS: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients. BioMed Central 2020-01-03 /pmc/articles/PMC6942399/ /pubmed/31900133 http://dx.doi.org/10.1186/s12888-019-2418-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kern, David M. Cepeda, M. Soledad Defalco, Frank Etropolski, Mila Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title | Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title_full | Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title_fullStr | Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title_full_unstemmed | Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title_short | Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019 |
title_sort | treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the united states: 2014 through 2019 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942399/ https://www.ncbi.nlm.nih.gov/pubmed/31900133 http://dx.doi.org/10.1186/s12888-019-2418-7 |
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