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Effect of communicating depression severity on physician prescribing patterns: findings from the Clinical Outcomes in MEasurement-based Treatment (COMET) trial
- Source :
-
General Hospital Psychiatry . Mar2012, Vol. 34 Issue 2, p105-112. 8p. - Publication Year :
- 2012
-
Abstract
- Abstract: Objective: In this secondary analysis from the Clinical Outcomes in MEasurement-based Treatment trial (COMET), we evaluated whether providing primary care physicians with patient-reported feedback regarding depression severity affected pharmacological treatment patterns. Method: Intervention-arm physicians received their patients'' 9-item Patient Health Questionnaire scores monthly. Odds of having no change in antidepressant treatment during the 6-month study period were calculated. Relationships between depression symptom status (partial or nonresponse) at month 3 and treatment changes in months 3 through 6 were assessed. Results: Among 503 intervention and 412 usual care (UC) patients with major depressive disorder, most received antidepressant monotherapy at baseline (79.4% UC vs. 88.4% intervention; P=.047). Few switched their baseline antidepressant (17.4%), increased their dose (12.4%) or augmented with a second medication (2%). Odds of having no change in antidepressant therapy did not differ significantly between study arms (odds ratio 1.21; 95% confidence interval 0.78–1.88; P=.392). Few month 3 partial or nonresponders had a regimen change over the following 3 months; the study arms did not differ significantly (partial responders: 4.1% UC vs. 7.7% intervention; P=.429; nonresponders: 14.6% UC vs. 15.9% intervention; P=.888). Conclusions: Among depressed patients treated in primary care, little active management was observed. The lack of treatment modification for the majority of partial and nonresponders was notable. [Copyright &y& Elsevier]
- Subjects :
- *MENTAL depression
*DIAGNOSIS of mental depression
*ANTIDEPRESSANTS
*CLINICAL trials
*COMMUNICATION
*CONFIDENCE intervals
*DRUG prescribing
*EPIDEMIOLOGY
*HEALTH outcome assessment
*PHYSICIAN-patient relations
*GENERAL practitioners
*PRIMARY health care
*QUESTIONNAIRES
*PHYSICIAN practice patterns
*DATA analysis
*SECONDARY analysis
*TREATMENT effectiveness
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 01638343
- Volume :
- 34
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- General Hospital Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 72339354
- Full Text :
- https://doi.org/10.1016/j.genhosppsych.2011.12.003