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
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 Adm...
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| Veröffentlicht in: | General hospital psychiatry 2006-11, Vol.28 (6), p.465-474 |
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| creator | Jones, Laura E. Turvey, Carolyn Carney-Doebbeling, Caroline |
| description | 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 |
| doi_str_mv | 10.1016/j.genhosppsych.2006.08.002 |
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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.</description><identifier>ISSN: 0163-8343</identifier><identifier>EISSN: 1873-7714</identifier><identifier>DOI: 10.1016/j.genhosppsych.2006.08.002</identifier><identifier>PMID: 17088161</identifier><identifier>CODEN: GHPSDB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aftercare - standards ; Aged ; Antidepressive Agents - therapeutic use ; Biological and medical sciences ; Clinical practice guidelines ; Demography ; Depression ; Depressive Disorder, Major - drug therapy ; Depressive Disorder, Major - epidemiology ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Female ; Follow-up care ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Mental health ; Mental Health Services - standards ; Middle Aged ; Neuropharmacology ; Organization of mental health. Health systems ; Pharmacology. Drug treatments ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychopharmacology ; Retrospective Studies ; Social psychiatry. Ethnopsychiatry ; United States ; United States Department of Veterans Affairs - statistics & numerical data ; Veterans - psychology ; Veterans - statistics & numerical data ; Veterans Health Administration</subject><ispartof>General hospital psychiatry, 2006-11, Vol.28 (6), p.465-474</ispartof><rights>2006 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-9a4b8eb03f60d43a6b5aa925766076f250b2c59d4af12fa514a4daf7d0a7dc8a3</citedby><cites>FETCH-LOGICAL-c408t-9a4b8eb03f60d43a6b5aa925766076f250b2c59d4af12fa514a4daf7d0a7dc8a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.genhosppsych.2006.08.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18324944$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17088161$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jones, Laura E.</creatorcontrib><creatorcontrib>Turvey, Carolyn</creatorcontrib><creatorcontrib>Carney-Doebbeling, Caroline</creatorcontrib><title>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</title><title>General hospital psychiatry</title><addtitle>Gen Hosp Psychiatry</addtitle><description>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.</description><subject>Adult</subject><subject>Aftercare - standards</subject><subject>Aged</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Clinical practice guidelines</subject><subject>Demography</subject><subject>Depression</subject><subject>Depressive Disorder, Major - drug therapy</subject><subject>Depressive Disorder, Major - epidemiology</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Follow-up care</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental health</subject><subject>Mental Health Services - standards</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Organization of mental health. Health systems</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Retrospective Studies</subject><subject>Social psychiatry. Ethnopsychiatry</subject><subject>United States</subject><subject>United States Department of Veterans Affairs - statistics & numerical data</subject><subject>Veterans - psychology</subject><subject>Veterans - statistics & numerical data</subject><subject>Veterans Health Administration</subject><issn>0163-8343</issn><issn>1873-7714</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQxiMEokvhFZCFBLcEO3YSL7eq_GmlSlyAqzWxJ12vEju1nVZ9Lx4Q725QOXLy2P5934zmK4p3jFaMsvbjvrpFt_NxnuOj3lU1pW1FZUVp_azYMNnxsuuYeF5sMsxLyQU_K17FuKeUNnXDXxZnrKNSspZtit_XDgzeLZCQDH4c_UO5zERDOFwDMTgHjNF6R8AZYlMkdppBJ3J8SXYFcklSQEgT5sosAdJRM3l3S-4xYQAXyYNNu6PPofBLBi30-TOSCcfRpiW7O5J2SH79lVwhjFl0YSbrbEwn39fFiwHGiG_W87z4-fXLj8ur8ub7t-vLi5tSCypTuQXRS-wpH1pqBIe2bwC2ddO1Le3aoW5oX-tmawQMrB6gYQKEgaEzFDqjJfDz4sPJdw7-bsGY1GSjzqOCQ79E1UpWc9rIDH46gTr4GAMOag52gvCoGFWHzNRe_ZuZOmSmqFQ5syx-u3ZZ-gnNk3QNKQPvVwCihnHIi9E2PnGS12IrROY-nzjMO7m3GFTUFp1GYwPqpIy3_zPPHybiwo0</recordid><startdate>20061101</startdate><enddate>20061101</enddate><creator>Jones, Laura E.</creator><creator>Turvey, Carolyn</creator><creator>Carney-Doebbeling, Caroline</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20061101</creationdate><title>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</title><author>Jones, Laura E. ; Turvey, Carolyn ; Carney-Doebbeling, Caroline</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-9a4b8eb03f60d43a6b5aa925766076f250b2c59d4af12fa514a4daf7d0a7dc8a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aftercare - standards</topic><topic>Aged</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Clinical practice guidelines</topic><topic>Demography</topic><topic>Depression</topic><topic>Depressive Disorder, Major - drug therapy</topic><topic>Depressive Disorder, Major - epidemiology</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Follow-up care</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental health</topic><topic>Mental Health Services - standards</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Organization of mental health. Health systems</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Retrospective Studies</topic><topic>Social psychiatry. Ethnopsychiatry</topic><topic>United States</topic><topic>United States Department of Veterans Affairs - statistics & numerical data</topic><topic>Veterans - psychology</topic><topic>Veterans - statistics & numerical data</topic><topic>Veterans Health Administration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jones, Laura E.</creatorcontrib><creatorcontrib>Turvey, Carolyn</creatorcontrib><creatorcontrib>Carney-Doebbeling, Caroline</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>General hospital psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jones, Laura E.</au><au>Turvey, Carolyn</au><au>Carney-Doebbeling, Caroline</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>General hospital psychiatry</jtitle><addtitle>Gen Hosp Psychiatry</addtitle><date>2006-11-01</date><risdate>2006</risdate><volume>28</volume><issue>6</issue><spage>465</spage><epage>474</epage><pages>465-474</pages><issn>0163-8343</issn><eissn>1873-7714</eissn><coden>GHPSDB</coden><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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17088161</pmid><doi>10.1016/j.genhosppsych.2006.08.002</doi><tpages>10</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aftercare - standards Aged Antidepressive Agents - therapeutic use Biological and medical sciences Clinical practice guidelines Demography Depression Depressive Disorder, Major - drug therapy Depressive Disorder, Major - epidemiology Diabetes mellitus Diabetes Mellitus - epidemiology Female Follow-up care Follow-Up Studies Humans Male Medical sciences Mental health Mental Health Services - standards Middle Aged Neuropharmacology Organization of mental health. Health systems Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Retrospective Studies Social psychiatry. Ethnopsychiatry United States United States Department of Veterans Affairs - statistics & numerical data Veterans - psychology Veterans - statistics & numerical data Veterans Health Administration |
| title | 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 |
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