Clinical Drug Investigation

, Volume 16, Issue 2, pp 135–140

Antidepressant Prescribing Patterns

A Comparison of Blacks and Whites in a Medicaid Population
  • David A. Sclar
  • Linda M. Robison
  • Tracy L. Skaer
  • W. Michael Dickson
  • Christopher M. Kozma
  • C. Eugene Reeder
Pharmacoepidemiology

DOI: 10.2165/00044011-199816020-00006

Cite this article as:
Sclar, D.A., Robison, L.M., Skaer, T.L. et al. Clin. Drug Investig. (1998) 16: 135. doi:10.2165/00044011-199816020-00006
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Abstract

Objective: This paper reports results stemming from a retrospective inquiry designed to determine the prescribing pattern of tricyclic antidepressants (TCAs) relative to selective serotonin reuptake inhibitors (SSRIs), and the subsequent effect on regimen adherence among African American (Black) and White beneficiaries enrolled in the state of South Carolina Medicaid programme.

Patients and Methods: Adjudicated patient-level paid-claims data for the time-frame 1 January 1990 to 31 December 1994 were abstracted resulting in a statewide cohort of 8596 ambulatory beneficiaries, 18 to 64 years of age, without receipt of antidepressant pharmacotherapy in the 1-year time-frame prior to initiating a regimen of either a TCA or SSRI, and remaining Medicaid-eligible for 1 year thereafter.

Results: Black race [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.43 to 1.70], age 40 to 64 years (OR = 1.15, 95% CI = 1.06 to 1.26), and male gender (OR = 1.27, 95% CI = 1.14 to 1.41) were significant predictors of initiating antidepressant pharmacotherapy with a TCA. Relative to Whites, Blacks were found to be less likely to have obtained at least a 3-month (≥90 days) supply of a TCA (22.1 vs 31.7%) or an SSRI (30.7 vs 36.1%), or to have obtained a 6-month (≥180 days) supply of a TCA (6.4 vs 10.9%) or an SSRI (8.1 vs 13.2%).

Conclusion: Further prospective research is required to discern the reasons for observed differences in prescribing and adherence patterns for antidepressant pharmacotherapy by age, gender and race, and to foster the development of educational programming designed to ensure clinically rational and equitable access to pharmacotherapeutic innovation.

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • David A. Sclar
    • 1
    • 2
    • 3
  • Linda M. Robison
    • 1
  • Tracy L. Skaer
    • 1
    • 4
  • W. Michael Dickson
    • 5
  • Christopher M. Kozma
    • 5
  • C. Eugene Reeder
    • 5
  1. 1.College of PharmacyWashington State UniversityPullmanUSA
  2. 2.Program in StatisticsWashington State UniversityPullmanUSA
  3. 3.Eastern BranchWashington Institute for Mental Illness Research and TrainingSpokaneUSA
  4. 4.Pullman Memorial HospitalPullmanUSA
  5. 5.Center for Pharmaceutical EconomicsCollege of Pharmacy, University of South CarolinaColumbiaUSA

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