TY - JOUR
T1 - Serotonin reuptake inhibitors and the adequacy of antidepressant treatment
AU - Shasha, Michelle
AU - Lyons, John S.
AU - O'Mahoney, Michael T.
AU - Miller, Sheldon I.
AU - Howard, Kenneth I.
AU - Rosenberg, Alan
PY - 1997
Y1 - 1997
N2 - Objective: To determine whether the use of sarotonin reuptake inhibitors (SSRIs) improves antidepressant medication prescribing patterns for both psychiatric and non-psychiatric physicians Data Sources/Setting: Drug utilization review of 4,103 prescriptions for antidepressant medications with patients diagnosed with depressive disorders over an eighteen-month period from the formulary records of a large insurance company. Design: Using standards developed for clinical guidelines, variation in trial and treatment adequacy between drag types and physician specialty was studied. Principal Findings: Thirty-five percent of initial antidepressant trials were not prescribed for an adequate duration or at an adequate dosage level. SSRIs were more likely to be prescribed adequately than any other antidepressant reviewed. Psychiatrists were more likely to prescribe antidepressants at an adequate dosage level, whereas non-psychiatric physicians were more likely to attain adequate duration of treatment. Conclusions: A greater reliance on SSRIs may increase the likelihood of maintaining adequacy in antidepressant treatments. Although higher in cost than other treatment choices, their lower side effect profile is likely to maximize patient satisfaction and physician and patient adherence to guidelines. In order to ensure effective and efficient antidepressant usage, such patterns must be identified and appropriate performance improvement strategies (e.g., Total Quality Improvement, critical pathways) may be employed.
AB - Objective: To determine whether the use of sarotonin reuptake inhibitors (SSRIs) improves antidepressant medication prescribing patterns for both psychiatric and non-psychiatric physicians Data Sources/Setting: Drug utilization review of 4,103 prescriptions for antidepressant medications with patients diagnosed with depressive disorders over an eighteen-month period from the formulary records of a large insurance company. Design: Using standards developed for clinical guidelines, variation in trial and treatment adequacy between drag types and physician specialty was studied. Principal Findings: Thirty-five percent of initial antidepressant trials were not prescribed for an adequate duration or at an adequate dosage level. SSRIs were more likely to be prescribed adequately than any other antidepressant reviewed. Psychiatrists were more likely to prescribe antidepressants at an adequate dosage level, whereas non-psychiatric physicians were more likely to attain adequate duration of treatment. Conclusions: A greater reliance on SSRIs may increase the likelihood of maintaining adequacy in antidepressant treatments. Although higher in cost than other treatment choices, their lower side effect profile is likely to maximize patient satisfaction and physician and patient adherence to guidelines. In order to ensure effective and efficient antidepressant usage, such patterns must be identified and appropriate performance improvement strategies (e.g., Total Quality Improvement, critical pathways) may be employed.
KW - Antidepressant medication
KW - Depression
KW - Drug utilization review
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U2 - 10.2190/YVBE-MXAF-Q09Q-Y02Q
DO - 10.2190/YVBE-MXAF-Q09Q-Y02Q
M3 - Article
C2 - 9565716
AN - SCOPUS:1842300436
SN - 0091-2174
VL - 27
SP - 83
EP - 92
JO - International Journal of Psychiatry in Medicine
JF - International Journal of Psychiatry in Medicine
IS - 2
ER -