Treatment Patterns and Sequences of Pharmacotherapy for Patients Diagnosed with Depression in the United States: 2014 through 2019
Background: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. Methods: Patients with depression were identified from four large national claims databases during 1/1/2014-1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and three years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. Results: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29% to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. Conclusions: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.
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Posted 19 Dec, 2019
On 03 Jan, 2020
On 22 Dec, 2019
On 17 Dec, 2019
On 16 Dec, 2019
On 16 Dec, 2019
On 13 Dec, 2019
Received 08 Dec, 2019
On 24 Nov, 2019
Invitations sent on 22 Nov, 2019
On 22 Nov, 2019
Received 22 Nov, 2019
On 11 Nov, 2019
On 10 Nov, 2019
On 10 Nov, 2019
On 04 Nov, 2019
On 30 Oct, 2019
Received 30 Oct, 2019
Received 29 Oct, 2019
On 16 Oct, 2019
Invitations sent on 11 Oct, 2019
On 08 Oct, 2019
On 02 Oct, 2019
On 01 Oct, 2019
On 01 Oct, 2019
Treatment Patterns and Sequences of Pharmacotherapy for Patients Diagnosed with Depression in the United States: 2014 through 2019
Posted 19 Dec, 2019
On 03 Jan, 2020
On 22 Dec, 2019
On 17 Dec, 2019
On 16 Dec, 2019
On 16 Dec, 2019
On 13 Dec, 2019
Received 08 Dec, 2019
On 24 Nov, 2019
Invitations sent on 22 Nov, 2019
On 22 Nov, 2019
Received 22 Nov, 2019
On 11 Nov, 2019
On 10 Nov, 2019
On 10 Nov, 2019
On 04 Nov, 2019
On 30 Oct, 2019
Received 30 Oct, 2019
Received 29 Oct, 2019
On 16 Oct, 2019
Invitations sent on 11 Oct, 2019
On 08 Oct, 2019
On 02 Oct, 2019
On 01 Oct, 2019
On 01 Oct, 2019
Background: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. Methods: Patients with depression were identified from four large national claims databases during 1/1/2014-1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and three years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. Results: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29% to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. Conclusions: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.
Figure 1
Figure 2
Figure 3