title: Do Latino and non-Latino White Medicaid-enrolled adults differ in utilization of evidence-based treatment for major depressive disorder?
abstract: Although evidence-based practice guidelines have been developed to achieve greater consistency and quality in mental health care, insufficient research exists on implementing these guidelines among different racial/ethnic groups and the impact of guideline adherence on treatment outcomes. This study compared mental health care received by community dwelling Latino and non-Latino White Medicaid enrollees in Florida with a diagnosis of major depressive disorder (MDD) and examined predictors of adherence to American Psychiatric Association (APA) guidelines for the treatment of MDD. Latinos were more likely than Whites to receive guideline adherent treatment (OR = 1.21, P < .0001). Enrollees receiving combination drug therapy were most likely to receive treatment consistent with APA guidelines (OR = 4.25, P < .0001). Despite research demonstrating the efficacy of evidence-based practices, many study participants did not receive guideline adherent treatment. Policies and practices targeted at increasing adherence to approved guidelines and improving treatment outcomes are recommended.
authors.affiliation: Department of Aging and Mental Health Disparities, University of South Florida, Tampa, FL 33612-3807, USA. mbecker2@usf.edu
authors.forename: Marion A
authors.initials: MA
authors.lastname: Becker
authors.forename: Dinorah
authors.initials: D
authors.lastname: Martinez-Tyson
authors.forename: Joshua
authors.initials: J
authors.lastname: DiGennaro
authors.forename: Ezra
authors.initials: E
authors.lastname: Ochshorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D005431:Florida; D019983:Guideline Adherence; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014481:United States; D044465:White People / Q000523:psychology*; D055815:Young Adult