Follow-up visits by provider specialty for patients with major depressive disorder initiating antidepressant treatment.
OBJECTIVE
This study examined the association between provider specialty and guideline-concordant care after the initiation of antidepressant treatment.


METHODS
Medical and prescription claims were analyzed from adults newly diagnosed as having major depressive disorder who initiated antidepressant treatment. Follow-up visits during the first 90 days after the index prescription were identified, and an indicator for receipt of guideline-concordant care (three or more visits) was created. Logistic regression models were used, and propensity score matching techniques were applied. Sensitivity analyses were conducted to investigate how results differed by varying the approach to identify follow-up visits.


RESULTS
The study included 4,102 patients, and only 31% received guideline-concordant follow-up visits. Patients receiving their initial prescription from psychiatrists were nearly five times as likely as patients receiving their initial prescription from primary care providers to receive guideline-concordant follow-up care (odds ratio=4.6, 95% confidence interval=3.9-5.4).


CONCLUSIONS
Routine care for antidepressant management falls short of guideline recommendations, especially in primary care.
Chen
Shih-Yin
SY
Abt Bio-Pharma Solutions, Inc., Lexington, MA 02421, USA. shih-yin.chen@abtbiopharma.com
Hansen
Richard A
RA
Farley
Joel F
JF
Gaynes
Bradley N
BN
Morrissey
Joseph P
JP
Maciejewski
Matthew L
ML
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003266:Continuity of Patient Care; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007345:Insurance Claim Review; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D014789:Visitors to Patients
D000928:Antidepressive Agents