Cross-generational comparison of dispensed pharmacotherapy for depression.
OBJECTIVE
The purpose of this paper is to compare predictors of receipt of recommended first-line pharmacotherapy in three generational cohorts of patients with new episode depression.


METHODS
This retrospective database cohort study included adolescent, adult and senior Quebec Public Prescription Drug Insurance Plan beneficiaries with new episode depression, who were diagnosed by primary care physicians or psychiatrists (October 2000 to March 2001) and received pharmacotherapy. Receipt of recommended first-line pharmacotherapy, based on the first psychoactive medication dispensed following the depression diagnosis, was defined according to Canadian guidelines.


RESULTS
Receipt of first-line pharmacotherapy was documented in 52 percent, 71 percent and 50 percent of adolescents, adults and seniors, respectively. Among adolescents and seniors, diagnosis by a psychiatrist was associated with a lower likelihood of receipt of recommended pharmacotherapy. Adolescent females and senior males were more likely and adults with comorbidity were less likely to receive recommended pharmacotherapy. For all age groups, having a physician who both diagnosed the depression and prescribed the initial pharmacotherapy was associated with an increased likelihood of receiving recommended pharmacotherapy. Relational continuity of care influenced receipt of recommended first-line pharmacotherapy. Gender differences in treatment were found in adolescents and seniors.


CONCLUSIONS
This paper identifies predictors of receipt of recommended first-line pharmacotherapy in three generational cohorts of patients with new episode depression.
Sewitch
Maida J
MJ
Department of Medicine, McGill University, Montreal, Canada. maida.sewitch@mcgill.ca
Bexton
Brian
B
Rahme
Elham
E
Galarneau
Sophie
S
Blais
Régis
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
D014150:Antipsychotic Agents