title: Disparities in outpatient antidepressant prescribing patterns and determinants of resource utilization at a tertiary care cancer center.
abstract: Our objective was to assess the prevalence of use of different classes of antidepressants, prescribing patterns, and determinants of exposure to specific types of antidepressants and resource utilization at a comprehensive cancer center from 2001 to 2006. Data were collected from the institution's outpatient pharmacy database and cross-referenced with the institution's electronic medical record system. Data collected included demographic characteristics, cancer diagnosis, comorbidities, prescribing physician and service, type and number of antidepressant prescriptions, and resource utilization. Significant differences in the usage and prescribing patterns of the type of antidepressants were found in the analysis by gender and ethnicity, with women seeing a psychiatrist more often than men (P = 0.001) and Caucasians receiving more selective serotonin reuptake inhibitors (SSRIs) than other ethnic groups (P = 0.002). In terms of resource utilization, men had significantly more hospital admissions (P < 0.0001) and emergency room visits (P = 0.004) than women, whereas non-Caucasian ethnic groups had more emergency room visits (P < 0.0001) and clinic visits (P = 0.001) than Caucasians. Further investigation of men and non-Caucasians in the screening, evaluation, and treatment of depression is necessary to confirm disparities and evaluate their possible causes.
authors.affiliation: Division of Pharmacy, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe, Unit 90, Houston, Texas 77030, USA. llal@mdanderson.org
authors.forename: Lincy S
authors.initials: LS
authors.lastname: Lal
authors.forename: Lesley-Ann N
authors.initials: LA
authors.lastname: Miller
authors.forename: Rebecca
authors.initials: R
authors.lastname: Arbuckle
authors.forename: Frank
authors.initials: F
authors.lastname: Hung
authors.forename: Chun
authors.initials: C
authors.lastname: Feng
authors.forename: Andrea
authors.initials: A
authors.lastname: Adamus
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents