Quality of care for medicaid-covered youth treated with antidepressant therapy.
BACKGROUND
Although antidepressant use has increased in pediatric populations, few studies have addressed the quality of follow-up care or duration of treatment for depressed youth.


OBJECTIVE
To evaluate the quality of care for antidepressant-treated youth, using the Health Plan Employer Data and Information Set guidelines (>or=3 visits in the 3 months after a new antidepressant prescription fill and continuation of antidepressant use at 3 and 6 months) as a benchmark.


METHODS
Administrative records were examined for 1205 Medicaid-covered youth (aged 5-18 years) who presented with a "new episode" of depression in 1998. Statistics were generated to describe the number of follow-up visits and duration of treatment within 6 months of first prescription fill.


RESULTS
A total of 507 (42.1%) youth with new episodes of depression were treated with antidepressants. Selective serotonin reuptake inhibitors accounted for 80.9% of prescriptions. Twenty-eight percent (28.1%) of youth with an antidepressant fill had 3 or more follow-up visits in the subsequent 3 months; however, an additional 29.2% had no further provider visits. Selective serotonin reuptake inhibitors were continued by 46.6% of treated youth at 3 months and by 26.3% at 6 months.


CONCLUSIONS
Many antidepressant-treated youth do not receive adequate follow-up or duration of treatment. Future studies should address reasons for poor follow-up and methods to improve monitoring for these youth.
Richardson
Laura P
LP
Child Health Institute and Department of Pediatrics, University of Washington, Seattle, USA. lpr@u.washington.edu
DiGiuseppe
David
D
Christakis
Dimitri A
DA
McCauley
Elizabeth
E
Katon
Wayne
W
D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000592:standards; D003866:Depressive Disorder / Q000188:drug therapy*; D004334:Drug Administration Schedule; D017050:Episode of Care; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000592:standards*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors