Factors associated with duration of new antidepressant treatment: analysis of a large primary care database

Explaining the variation between practices in the duration of new antidepressant treatment: a database cohort study in primary care

“…9 The current study found that independently of patient characteristics, practice characteristics meaningfully impact on duration of antidepressant treatment. This is in keeping with a Danish study, 8 which observed a systematic difference between practices in the proportion of patients who only collected …”

“…The methods for identifying newly initiated antidepressant treatment have previously been described in detail. 9 Briefly, eligible patients received one or more prescriptions for an eligible antidepressant -any SSRI, venlafaxine, mirtazapine, lofepramine, or trazodonein the 12-month period beginning 1 April 2007 and had received no prescriptions for a similar drug in the preceding 12 months. Duration of treatment was estimated from the date, dose, frequency, and quantity characteristics of each prescription, and from the interval between first and last prescriptions.…”

“…1,2 Previous research, in a large primary care database cohort, found that duration of treatment was only weakly influenced by patient characteristics including age, sex, socioeconomic deprivation, physical comorbidity, and history of past treatment. 9 Multilevel analysis in which patients were clustered by GP practice indicated that the GP practice accounted for a similar proportion of variance to the individual characteristics. One factor which may have related to either patient or GP -whether the GP had recorded a diagnostic code indicating a depressive or other mental health disorder for the episode of care during which antidepressant treatment was initiated -was the variable most strongly associated with duration of treatment.…”

Antidepressant Adherence Across Diverse Populations and Health Care Settings

“…12,[32][33][34] We also found that patients living in neighborhoods with lower levels of education had lower rates of antidepressant adherence, and although some studies found similar results, 28,34 others did not find education to have an effect. 29,30,35 In our population, patients with higher comorbidity burden were more likely to adhere to their antidepressant medications, perhaps due to a learning effect, having a routine for consistently taking medications, or having a better understanding of the negative effects of stopping chronic disease medications.…”

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“…Database studies from England 1 and Scotland 2 have shown trends over time towards longer courses of treatment and a recent study 3 casts further light on new, or incident, prescribing. This study examined antidepressant prescriptions for patients who started treatment over one 12-month period and who had not received an antidepressant in the preceding year.…”