Measuring the Quality of Depression Care in a Large Integrated Health System

Charbonneau, Andrea; Rosen, Amy K.; Ash, Arlene S.; Owen, Richard R.; Kader, Boris; Spiro, Avron; Hankin, Cheryl S.; Herz, Lawrence; Pugh, Mary Jo; Kazis, Lewis E.; Miller, Donald R.; Berlowitz, Dan R.

doi:10.1097/01.mlr.0000062920.51692.b4

Cited by 83 publications

(59 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More recent work has documented persistent inadequacy of treatment in VA hospitals (Charbonneau et al, 2003). In addition, Weilburg et al (2003) conducted a retrospective analysis using pharmacy claims made by patients with a primary care physician in a managed care plan at an academic medical center from 1996 through 1999.…”

Section: Introductionmentioning

confidence: 99%

Chronic forms of major depression are still undertreated in the 21st century: Systematic assessment of 801 patients presenting for treatment

Kocsis

Gelenberg

Rothbaum

et al. 2008

Journal of Affective Disorders

View full text Add to dashboard Cite

During a multisite, NIMH-sponsored clinical trial entitled, "Research Evaluating the Value of Augmentation of Medication by Psychotherapy" (REVAMP), we assessed the adequacy of prior antidepressant treatment in patients with chronic forms of major depressive disorder using the Antidepressant Treatment History Form (ATHF). We hypothesized that when compared to earlier studies treatment adequacy would not have increased over the past decade.We found that only 33% of the 801 subjects enrolled had ever had a prior adequate trial of antidepressant medication. Patients significantly more likely to have received prior adequate antidepressant trials were older, married, white, had a longer duration of illness, had more melancholic features or met criteria for the melancholic subtype or met lifetime criteria for panic disorder.The hypothesis that rates of treatment adequacy have not significantly increased over the past decade was supported. These results and the consistency of similar results over time point to the dire need for patient and provider education regarding the signs and symptoms of depression and its treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Chronic forms of major depression are still undertreated in the 21st century: Systematic assessment of 801 patients presenting for treatment

Kocsis

Gelenberg

Rothbaum

et al. 2008

Journal of Affective Disorders

View full text Add to dashboard Cite

show abstract

“…Numerous studies have documented high rates of discontinuation of antidepressants, 3,[8][9][10][11][12][13][14][15] with one review reporting that between 45 and 60% of patients stop taking prescribed antidepressants within 3 months of beginning treatment. 14 A minimum of six to nine months of pharmacotherapy is recommended for depression treatment after symptoms resolve, 16 17 but given the chronic and recurring nature of most other indications for antidepressants (e.g.…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of Antidepressant Medication Among Latinos in the USA

Hodgkin

Volpe-Vartanian

Alegrı́a

2007

J Behav Health Serv Res

View full text Add to dashboard Cite

Despite recent growth in the variety of antidepressant medications available, many patients discontinue medication prematurely, for reasons such as nonresponse, side effects, stigma and miscommunication. Some analysts have suggested that Latinos may have higher antidepressant discontinuation rates than other US residents. This paper examines Latino antidepressant discontinuation, using data from a national probability survey of Latinos in the US. In this sample, 8% of Latinos had taken an antidepressant in the preceding 12 months. Among those users, 33.3% had discontinued taking antidepressants at the time of interview, and 18.9% had done so without prior input from their physician. Even controlling for clinical and other variables, patients who reported good or excellent English proficiency were less likely to stop at all. Patients were also less likely to stop if they were older, married, had public or private insurance, or had made eight or more visits to a nonmedical therapist.

show abstract

“…We assessed outpatient prescription data for antidepressant medications in the same 6 month period, excluding low dose tricyclic and other antidepressants commonly used for non-depression indications. 18 We computed prevalence of treatment among those with at least one diagnosis of depression in the denominator and those with at least one antidepressant prescription or mental health visit in the numerator.…”

Section: Methodsmentioning

confidence: 99%

“…15,16 Even though the VA has effectively implemented annual depression screening in primary care (PC) clinics, with recent composite behavioral screening rates above 90% in all VA regions, 17 and the majority of veterans with diagnosed depression receive an antidepressant, 18,19 the duration and follow-up of antidepressant treatment is frequently inadequate. [18][19][20] Despite their higher risk of depression, veterans with recent ischemic stroke, have not been targeted for depression screening. Some studies suggest that diseasespecific quality improvement efforts are likely necessary to achieve improvements in depression care and outcomes, 21 and our prior data show that veterans and VA providers report unique difficulties with depression recognition and treatment post-stroke.…”

Section: Introductionmentioning

confidence: 99%