Resident physician management of Hispanic and non-Hispanic white patients on antidepressants.
OBJECTIVE
The purpose of this study was to examine how well resident physicians monitored Hispanic and non-Hispanic white patients who were prescribed antidepressant medication.


METHODS
Retrospective and prospective review of patients' medical records.


METHODS
Family practice and internal medicine clinics at the University of New Mexico Health Sciences Center.


METHODS
Twenty-six resident physicians and 109 of their Hispanic and non-Hispanic white patients who were prescribed antidepressant medication when recruited into the study between March and December 1995.


METHODS
(i) Whether a physician recorded an appropriate diagnosis in the patient's chart, scheduled a follow-up visit and saw the patient for a follow-up visit within four weeks of the antidepressant being prescribed, and (ii) whether a physician recorded an adequate treatment plan, a discussion of side-effects and a discussion of how well the medication was working on the date the patient was enrolled in the study.


RESULTS
Twenty-seven percent of patients were prescribed antidepressant medication. Less than half of the patients who were prescribed an antidepressant had a follow-up visit scheduled and only about one-third of patients were seen by their physician within one month of the antidepressant being prescribed. Physicians documented an adequate treatment plan in the charts of 51.1% of patients, a discussion of side-effects in 11.1% of charts and an assessment of how well the medication was working in 33.3% of charts. Younger patients and patients in better emotional health were more likely to have an adequate treatment plan documented in their chart. Patients in poorer physical health were more likely to have an adequate treatment plan documented in their chart along with a description of the effectiveness of the medication. Hispanic and non-Hispanic white patients who were prescribed antidepressants were monitored equally well by their primary care physicians.


CONCLUSIONS
Primary care resident physicians need further training on the importance of monitoring patients on antidepressant medication.
Sleath
B
B
School of Pharmacy, University of North Carolina at Chapel Hill, 27599-7360, USA. betsy_sleath@unc.edu
Rubin
R H
RH
Huston
S
S
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000592:standards*; D004282:Documentation; D016903:Drug Monitoring / Q000592:standards*; D005194:Family Practice / Q000193:education* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000592:standards; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D008485:Medical Audit; D008499:Medical Records; D008875:Middle Aged; D009516:New Mexico; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
D000928:Antidepressive Agents