Provider characteristics related to antidepressant use in older people.
OBJECTIVE
To determine whether the characteristics of the usual medical care providers of older antidepressant users changed between 1986 and 1997 with the introduction of selective serotonin reuptake inhibitors.


METHODS
Longitudinal study.


METHODS
Five-county Piedmont area of North Carolina.


METHODS
Stratified random sample of African-American (n=2,261) and white (n=1,875) community residents aged 65 to 105.


METHODS
Sample members provided information on prescription medications, demographic and health status, and usual medical care provider (matched to North Carolina Health Professions Data Systems files to ascertain provider characteristics) in 1986/87, 1989/90, 1992/93, and 1996/97. Most (77.5%) named a provider (name unmatchable for 4.1%). Sample member characteristics were aggregated into probability (propensity) scores summarizing predisposing (demographic), enabling (medical care access), and need (health status) categories. Along with wave of study and whether a provider was named, these were entered as control variables in generalized estimating equation models that examined the association between provider race (white vs nonwhite), sex, age, location of practice, and primary versus specialist care and antidepressant use.


RESULTS
The characteristics of the usual medical care providers remained stable over the decade, although prevalence of antidepressant use increased. Two provider characteristics--race and area of practice (but not the interaction between them)--were significantly associated with patients' use of antidepressants. Patients of white physicians and of physicians with urban practices were more likely to use antidepressants.


CONCLUSIONS
Although use of antidepressants has increased over time, there has been little change in the characteristics of users' usual medical care providers.
Fillenbaum
Gerda G
GG
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710, USA. ggf@geri.duke.edu
Hybels
Celia F
CF
Pieper
Carl F
CF
Konrad
Thomas R
TR
Burchett
Bruce M
BM
Blazer
Dan G
DG
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003071:Cognition; D003863:Depression / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel; D006304:Health Status; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies
D000928:Antidepressive Agents