title: Depression treatment patterns among adults with chronic obstructive pulmonary disease and depression.
abstract: To estimate rates and patterns of depression treatment among adults with chronic obstructive pulmonary disease (COPD) and depression.
  
  
  
  We used a retrospective, cross-sectional study design, pooling data from 2010 and 2012 Medical Expenditure Panel Survey (MEPS). The study sample consisted of 527 individuals aged 21 years or older, diagnosed with COPD and depression. Depression treatment was grouped into three categories based on those who received: (1) neither antidepressant nor psychotherapy; (2) antidepressants only; and (3) psychotherapy combined with antidepressants (combination therapy). We conducted chi-squared tests and multinomial logistic regressions to examine factors (demographic, socio-economic characteristics, healthcare access, health status, and personal health practices) associated with depression treatment among adults with COPD and depression.
  
  
  
  The mean age of the study sample was 55.96 years (SD = 13.36). Overall, 18.8% of the sample adults did not report any use of antidepressants or psychotherapy, 58.3% reported antidepressants use only and 23% reported using combination therapy. Females (adjusted odds ratio [AOR] = 1.89, 95% CI = 1.02, 3.55), older adults (≥65 years: AOR = 3.69, 95% CI = 1.62, 8.41), adults with fair/poor physical health status (AOR = 3.32, 95% CI = 1.29, 8.56) and those suffering from anxiety (AOR = 1.94, 95% CI = 1.09, 3.46) were more likely to receive antidepressant treatment. Older adults (AOR =2.94, 95% CI  = 1.05, 8.22), those who were never married (AOR = 3.17, 95% CI = 1.18, 8.56), suffered from anxiety (AOR =6.01, 95% CI = 3.11, 11.61) and current smokers (AOR = 2.29, 95% CI = 1.05, 4.98) were more likely to receive combination therapy. Whereas, adults who were uninsured (AOR = 0.21, 95% CI = 0.05, 0.86) and did not lacked regular physical activity (AOR = 0.33, 95% CI = 0.16, 0.67) were less likely to receive combination therapy. A key limitation of our study is that we could not control for the severity of depression or COPD which may have influenced depression treatment.
  
  
  
  Efforts to improve depression care among adults with co-occurring COPD and depression may need to be tailored for different subgroups.
authors.affiliation: a West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center , Morgantown , WV , USA.
authors.forename: Arijita
authors.initials: A
authors.lastname: Deb
authors.affiliation: a West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center , Morgantown , WV , USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Sambamoorthi
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000628:therapy*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; COPD; Depression Treatment; MEPS; Psychotherapy