Burton Wayne N, Chen Chin-Yu, Conti Daniel J, Schultz Alyssa B, Edington Dee W
Department of Environmental and Occupational Sciences, University of Illinois at Chicago, Chicago, Ill, USA.
Am J Manag Care. 2007 Feb;13(2):105-12.
To evaluate the relationship between antidepressant medication adherence and short-term disability (STD) in an employed population.
Retrospective observational cohort study of 2112 employees with a new episode of treatment with an antidepressant medication (selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors).
Both Health Plan Employer Data and Information Set (HEDIS) acute and continuation treatment guidelines were applied to categorize patients' medication adherence. STD events were followed for 365 days after the date that an initial antidepressant medication prescription was filled. The association between STD and adherence was analyzed with multiple logistic regression models, adjusting for demographic and other confounding factors.
A total of 1301 employees (61.6% of 2112) adhered to acute phase treatment, and 966 (45.7% of 2112) remained adherent to continuation phase treatment. After adjusting for sociodemographic factors, employees nonadherent with acute treatment were 38.7% more likely to have STD claims than adherent employees (odds ratio [OR] = 1.387; 95% confidence interval [CI] = 1.025, 1.876; P = .0339); and employees nonadherent with continuation treatment were 46.1% more likely to have STD claims than adherent employees (OR = 1.461; 95% CI = 1.071, 1.993; P = .0167).
A higher incidence of STD was associated with antidepressant medication nonadherence in both acute and continuation treatment phases. Employers may save indirect costs by providing assistance to encourage employees to adhere to their antidepressant medication treatment.
评估在职人群中抗抑郁药物依从性与短期残疾(STD)之间的关系。
对2112名开始使用抗抑郁药物(选择性5-羟色胺再摄取抑制剂或5-羟色胺去甲肾上腺素再摄取抑制剂)进行新一轮治疗的员工进行回顾性观察队列研究。
应用健康计划雇主数据与信息集(HEDIS)的急性期和延续期治疗指南对患者的药物依从性进行分类。在首次开具抗抑郁药物处方之日起365天内跟踪STD事件。采用多因素逻辑回归模型分析STD与依从性之间的关联,并对人口统计学和其他混杂因素进行校正。
共有1301名员工(占2112名的61.6%)坚持急性期治疗,966名(占2112名的45.7%)继续坚持延续期治疗。校正社会人口学因素后,急性期治疗不依从的员工发生STD索赔的可能性比依从的员工高38.7%(比值比[OR]=1.387;95%置信区间[CI]=1.025,1.876;P=0.0339);延续期治疗不依从的员工发生STD索赔的可能性比依从的员工高46.1%(OR=1.461;95%CI=1.071,1.993;P=0.0167)。
在急性期和延续期治疗阶段,STD的较高发生率均与抗抑郁药物不依从有关。雇主可通过提供援助以鼓励员工坚持抗抑郁药物治疗来节省间接成本。