title: Factors associated with duration of new antidepressant treatment: analysis of a large primary care database.
abstract: BACKGROUND
  It is not known how much the duration of newly prescribed antidepressant treatment is influenced by patient characteristics or practice variation.
  
  
  OBJECTIVE
  To describe the relationship between patient characteristics and the duration of new antidepressant  treatment by general practices.
  
  
  METHODS
  Large primary care database cohort study of all patients with a newly initiated course of eligible antidepressant treatment during 1 year, from a database of 237 Scottish practices.
  
  
  METHODS
  Detailed prescription  data were used to estimate the duration of new antidepressant treatment for each patient. Cox proportional hazards regression was used to estimate the influence of patient characteristics on continuation of treatment and, by multilevel modelling, the variation between practices.
  
  
  RESULTS
  A total of 28 027 (2.2%) patients commenced antidepressant treatment during the year; 75% continued beyond 30 days, 56% beyond 90 days, and 40% beyond 180 days. Treatment was less likely to be continued in patients from areas of high socioeconomic deprivation: hazard ratio 1.22 (95% confidence  interval [CI] = 1.16 to 1.29); in patients under 35 years, 1.33 (95% CI = 1.28 to 1.37); and in those for whom the GP recorded no relevant diagnostic code, 1.16 (95% CI = 1.13 to 1.18). Models accounted for between 2.2% and 3.9% of the variation in treatment duration.
  
  
  CONCLUSIONS
  Patient demographic characteristics account for relatively little variation in the duration of new antidepressant treatment, though treatment was shorter in younger patients and those with greater socioeconomic deprivation. There is variation in treatment duration between practices and  according to whether patients have a depression diagnosis coded in their records.
authors.affiliation: Centre for Population Health Sciences, The University of Edinburgh, Scotland, UK. chris.burton@ed.ac.uk
authors.forename: Christopher
authors.initials: C
authors.lastname: Burton
authors.forename: Niall
authors.initials: N
authors.lastname: Anderson
authors.forename: Katie
authors.initials: K
authors.lastname: Wilde
authors.forename: Colin R
authors.initials: CR
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D058006:General Practice; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012606:Scotland; D012959:Socioeconomic Factors
chemical_list: D000928:Antidepressive Agents