Academic Journal

Association between prescriber practices and major depression treatment outcomes

التفاصيل البيبلوغرافية
العنوان: Association between prescriber practices and major depression treatment outcomes
المؤلفون: Sarah Rathnam, Abhishek Sharma, Kamber L. Hart, Pilar F. Verhaak, Thomas H. McCoy, Roy H. Perlis, Finale Doshi-Velez
المصدر: Journal of Mood and Anxiety Disorders, Vol 8, Iss , Pp 100080- (2024)
بيانات النشر: Elsevier, 2024.
سنة النشر: 2024
المجموعة: LCC:Psychiatry
مصطلحات موضوعية: Major depression, Primary care, Psychopharmacology, Electronic health records, Health services, Antidepressants, Mental healing, RZ400-408, Psychiatry, RC435-571
الوصف: Practice variability may represent an opportunity to improve care by identifying the differences in outcomes associated with differences in practice. To characterize differences in depression treatment outcomes among individual providers in outpatient psychiatry practices and primary care practices, we examined a longitudinal cohort derived from outpatient electronic health records from two academic medical centers and six community hospitals in Eastern Massachusetts. This cohort included antidepressant-treated individuals with an ICD-9/10 diagnosis of major depressive disorder, and deidentified health care providers treating at least 10 such patients per year between 2008 and 2022. We examined the association between individual provider prescribing characteristics and proportions of treated patients who do not follow up after initial antidepressant prescription or who achieve a stable ongoing prescription. In binomial regression models, among 104 psychiatrists, greater heterogeneity in antidepressant prescribing and lesser proportion of serotonin reuptake inhibitors (SSRIs)1 prescribed were associated with greater rates of achieving stability (for heterogeneity, adjusted odds ratio AOR, 1.55 [95 % CI, 1.22 – 2.06]; for proportion of SSRIs, AOR, 0.01 [95 % CI, 0.00–0.59]). Among 369 primary care physicians, greater volume of depression encounters per year, but not prescribing heterogeneity, was associated with greater rates of achieving stability (for encounters, AOR, 2.15 [95 % CI, 1.61 – 2.89]; for heterogeneity, AOR, 0.99 [95 % CI, 0.85 – 1.15]). Primary care and psychiatry predictors are not the same and therefore suggest potentially distinct strategies to improve clinical outcomes in each setting. Trial Registration: N/A
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2950-0044
Relation: http://www.sciencedirect.com/science/article/pii/S2950004424000348; https://doaj.org/toc/2950-0044
DOI: 10.1016/j.xjmad.2024.100080
URL الوصول: https://doaj.org/article/5304d94f5562413489cd0728891843b5
رقم الانضمام: edsdoj.5304d94f5562413489cd0728891843b5
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:29500044
DOI:10.1016/j.xjmad.2024.100080