Impact of antidepressant dispensing on health service use among veterans with stroke.
OBJECTIVE
To examine the association between dispensing of a selective serotonin reuptake inhibitor (SSRI) antidepressant medication and inpatient and outpatient service use in a cohort of veterans with confirmed acute stroke.


METHODS
Retrospective study.


METHODS
Southeastern U. S. Veterans Health Administration (VHA) network, from October 1, 2000, to September 30, 2001.


METHODS
785 veterans with confirmed acute stroke.


METHODS
VHA and Medicare databases were used to obtain outcome information during the 12 months after the index stroke date.


METHODS
Number of inpatient admissions, length of inpatient stays, and number of outpatient clinic stops for all causes.


RESULTS
Among the study cohort (n = 785), 12% had an SSRI dispensed 30 days or less poststroke, 19% had an SSRI dispensed between 31 and 365 days poststroke, and 69% were not dispensed an SSRI poststroke. After adjusting for risk factors, no significant association was found between time to first SSRI dispensing and inpatient use. However, patients with an early SSRI dispensing were more likely to have a greater number of all-cause outpatient stops compared with patients with later or no SSRI dispensing. Regardless of time to first dispensing, patients dispensed an SSRI had more outpatient clinic stops than patients without the medication.


CONCLUSIONS
SSRI dispensing was not predictive of inpatient use but was a strong predictor of all-cause outpatient clinic stops.
Rehabilitation Outcome Research Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA. huanguang.jia@va.gov
Huanguang
H
Jia
L Douglas
LD
Ried
Hua
H
Feng
Randi
R
Cameon
Xinping
X
Wang
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D015144:Southeastern United States; D020521:Stroke / Q000150:complications* / Q000523:psychology; D014728:Veterans / Q000523:psychology*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors