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Journal cover: International Journal of Health Care Quality Assurance

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Online from: 1988

Subject Area: Health Care Management/Healthcare

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Cross-generational comparison of dispensed pharmacotherapy for depression


Document Information:
Title:Cross-generational comparison of dispensed pharmacotherapy for depression
Author(s):Maida J. Sewitch, (based at the Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Canada), Brian Bexton, (based at the Department of Psychiatry, University of Montreal, Montreal, Canada), Elham Rahme, (based at the Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Canada), Sophie Galarneau, (Based at the Department of Family Medicine, University of Montreal, Montreal, Canada), Régis Blais, (Based at the Department of Health Administration, University of Montreal, Montreal, Canada)
Citation:Maida J. Sewitch, Brian Bexton, Elham Rahme, Sophie Galarneau, Régis Blais, (2009) "Cross-generational comparison of dispensed pharmacotherapy for depression", International Journal of Health Care Quality Assurance, Vol. 22 Iss: 3, pp.300 - 312
Keywords:Depression, Drug controls, Drugs, Gender
Article type:Research paper
DOI:10.1108/09526860910953566 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:This research was supported by a grant from the Canadian Institutes of Health Research (CIHR MOP-53098). Paper presentations: part of this research was presented at a plenary session at the 41st Annual Congress of the Association des médecins psychiatres du Québec, Mont Tremblant, Canada, in June 2007. Dr Sewitch is supported as a research scientist of the Canadian Cancer Society through an award from the National Cancer Institute of Canada. Dr Bexton served as a participant on advisory boards for Organon and Eli Lilly and received payment for educational talks from Eli Lilly, Wyeth-Ayerst Pharmaceuticals, Organon, Pfizer Inc, Hoffmann-LaRoche, ICN Canada, Biovail, Bristol-Myers Squibb, and Lundbeck.
Abstract:

Purpose – The purpose of this paper is to compare predictors of receipt of recommended first-line pharmacotherapy in three generational cohorts of patients with new episode depression.

Design/methodology/approach – This retrospective database cohort study included adolescent, adult and senior Quebec Public Prescription Drug Insurance Plan beneficiaries with new episode depression, who were diagnosed by primary care physicians or psychiatrists (October 2000 to March 2001) and received pharmacotherapy. Receipt of recommended first-line pharmacotherapy, based on the first psychoactive medication dispensed following the depression diagnosis, was defined according to Canadian guidelines.

Findings – Receipt of first-line pharmacotherapy was documented in 52 percent, 71 percent and 50 percent of adolescents, adults and seniors, respectively. Among adolescents and seniors, diagnosis by a psychiatrist was associated with a lower likelihood of receipt of recommended pharmacotherapy. Adolescent females and senior males were more likely and adults with comorbidity were less likely to receive recommended pharmacotherapy. For all age groups, having a physician who both diagnosed the depression and prescribed the initial pharmacotherapy was associated with an increased likelihood of receiving recommended pharmacotherapy. Relational continuity of care influenced receipt of recommended first-line pharmacotherapy. Gender differences in treatment were found in adolescents and seniors.

Originality/value – This paper identifies predictors of receipt of recommended first-line pharmacotherapy in three generational cohorts of patients with new episode depression.



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