VA South Central Mental Illness Education and Clinic Center (MIRECC), Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA.
Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):377-9. doi: 10.1016/j.genhosppsych.2010.03.008. Epub 2010 May 4.
To estimate the correlation between antidepressant medication possession ratios (MPR) measured from administrative pharmacy data and changes in self-reported depression symptoms.
The sample includes 360 primary care patients enrolled in a randomized trial of collaborative care in the Department of Veterans Affairs. Treatment response at 6 months was defined as a 50% improvement in symptoms as measured by the Hopkins Symptom Checklist (SCL-20). MPRs were calculated from administrative pharmacy data. Logistic regression analysis (controlling for intervention status and casemix) was used to test the hypothesis that MPR was significantly associated with treatment response.
Seventy percent of the patients filled an antidepressant prescription and the average MPR was 0.46. A fifth (19.2%) of the patients responded to treatment. Having an MPR > or = 0.9 was significantly correlated with treatment response (OR=2.43, CI(95)=1.29-4.57, P=.006).
If the predictive validity of antidepressant MPR measured from administrative pharmacy data is validated in other patient populations, it could be used to estimate treatment response rates whenever it is not feasible to collect symptom data directly from patients. Thus, the effectiveness of quality improvement programs designed to increase rates of antidepressant initiation and adherence could potentially be evaluated routinely at the population or system level.
评估从行政药房数据中测量的抗抑郁药物持有率（MPR）与自我报告的抑郁症状变化之间的相关性。
该样本包括在退伍军人事务部合作护理随机试验中纳入的 360 名初级保健患者。6 个月时的治疗反应定义为症状改善 50%，采用霍普金斯症状清单（SCL-20）进行测量。MPR 是从行政药房数据中计算得出的。使用逻辑回归分析（控制干预状态和病例组合）来检验 MPR 与治疗反应显著相关的假设。
70%的患者开了抗抑郁药处方，平均 MPR 为 0.46。五分之一（19.2%）的患者对治疗有反应。MPR>或=0.9 与治疗反应显著相关（OR=2.43，CI（95）=1.29-4.57，P=0.006）。
如果从行政药房数据中测量的抗抑郁药 MPR 的预测有效性在其他患者群体中得到验证，那么在无法直接从患者收集症状数据的情况下，它可以用于估计治疗反应率。因此，旨在提高抗抑郁药起始和依从率的质量改进计划的有效性可以在人群或系统水平上定期进行评估。
