title: Initiation of antidepressant therapy: do patients follow the GP's prescription?
abstract: BACKGROUND
  The question whether patients actually start drug taking after having received a first antidepressant prescription is often overlooked.
  
  
  OBJECTIVE
  To determine the incidence of patients who do not fill or fill only a single antidepressant prescription at the pharmacy, and to identify associated patient characteristics.
  
  
  METHODS
  Retrospective study linking a general practice to a pharmacy dispensing database.
  
  
  METHODS
  General practice in the Netherlands.
  
  
  METHODS
  
  
  
  METHODS
  patients who received a first-time antidepressant prescription from a GP. Three patient groups were identified: patients who did not fill the prescription (non-fillers); patients who filled only a single prescription (single Rx-fillers); and patients who filled at least two consecutive prescriptions. Non-fillers and single Rx-fillers were combined into a group of decliners.
  
  
  RESULTS
  Of all 965 patients, 41 (4.2%) did not fill the prescription, and 229 (23.7%) filled only a single prescription. Patients who consulted their GP for a non-specific indication, rather than for depression, anxiety, panic, or obsessive-compulsive disorder, were almost three times more likely (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.8 to 3.9) to decline treatment. Further, the risk of declining was almost fivefold higher (OR = 4.8, 95% CI = 2.1 to 11.3) in non-Western immigrants, and almost twofold higher (OR = 1.8, 95% CI = 1.2 to 2.8) in patients >60 years of age.
  
  
  CONCLUSIONS
  Over one in four patients who receive a first-time antidepressant prescription decline treatment; they either do not initiate drug taking or do not persist with antidepressant use for longer than 2 weeks.
authors.affiliation: Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, the Netherlands.
authors.forename: Erica C G
authors.initials: EC
authors.lastname: van Geffen
authors.forename: Helga
authors.initials: H
authors.lastname: Gardarsdottir
authors.forename: Rolf
authors.initials: R
authors.lastname: van Hulten
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
authors.forename: Antoine C G
authors.initials: AC
authors.lastname: Egberts
authors.forename: Eibert R
authors.initials: ER
authors.lastname: Heerdink
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000928:Antidepressive Agents