Antidepressant Prescribing Patterns
- David A. SclarAffiliated withCollege of Pharmacy, Washington State UniversityProgram in Statistics, Washington State UniversityEastern Branch, Washington Institute for Mental Illness Research and Training Email author
- , Linda M. RobisonAffiliated withCollege of Pharmacy, Washington State University
- , Tracy L. SkaerAffiliated withCollege of Pharmacy, Washington State UniversityPullman Memorial Hospital
- , W. Michael DicksonAffiliated withCenter for Pharmaceutical Economics, College of Pharmacy, University of South Carolina
- , Christopher M. KozmaAffiliated withCenter for Pharmaceutical Economics, College of Pharmacy, University of South Carolina
- , C. Eugene ReederAffiliated withCenter for Pharmaceutical Economics, College of Pharmacy, University of South Carolina
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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.
- Antidepressant Prescribing Patterns
Clinical Drug Investigation
Volume 16, Issue 2 , pp 135-140
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- Springer International Publishing
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- 1. College of Pharmacy, Washington State University, P.O. Box 646510, Pullman, Washington, 99164-6510, USA
- 2. Program in Statistics, Washington State University, Pullman, Washington, USA
- 3. Eastern Branch, Washington Institute for Mental Illness Research and Training, Spokane, Washington, USA
- 4. Pullman Memorial Hospital, Pullman, Washington, USA
- 5. Center for Pharmaceutical Economics, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA