title: Sociodemographic and clinical factors associated with antidepressant type in a national sample of the home health care elderly.
abstract: OBJECTIVE
  The study examined in home health care (HHC) the demographic, functional and clinical factors by antidepressant (AD) type including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) and "Other" ADs such as bupropion and mirtazapine.
  
  
  METHODS
  Cross-sectional sample (N=909) was analyzed from the 2007 National Home Health and Hospice Care Survey that included patients 65 years and older [mean=78.79 years, confidence interval (CI)=77.88-79.69 years] taking one AD.
  
  
  RESULTS
  Selective serotonin reuptake inhibitors were the most commonly used (63.89%) AD, followed by "Other" ADs (14.29%), TCAs (11.31%) and SNRIs. In a multinomial regression referencing SSRIs, blacks had increased odds of tricyclic use compared to whites [odds ratio (OR)=5.96, CI=1.85-19.19]. Hispanics had decreased odds of "Other" AD (OR=0.13, CI=0.02-0.73) and SNRI use (OR=0.06, CI=0.008-0.45) compared to non-Hispanics. The HHC elderly taking psychotropic medications besides ADs were less likely to use SNRIs (OR=0.31, CI=0.11-0.88) and tricyclics (OR=0.27, CI=0.08-0.87). Advancing age was marginally associated with tricyclic use (OR=1.04, CI=0.99-1.09).
  
  
  CONCLUSIONS
  Race/ethnicity and age differences by AD type - including blacks' increased TCA use, Hispanics' decreased SNRI and "Other" AD use, and older elderly's increased tricyclic use - suggest systematic differences in prescribing practice variations including differences by geography, patient preferences or access to care in the HHC elderly.
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, White Plains, NY 10601, USA. juw7002@med.cornell.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Weissman
authors.forename: Barnett S
authors.initials: BS
authors.lastname: Meyers
authors.forename: Samiran
authors.initials: S
authors.lastname: Ghosh
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents