Bhattacharjee Sandipan, Lee Jeannie K, Vadiei Nina, Patanwala Asad E, Malone Daniel C, Knapp Shannon M, Lo-Ciganic Wei-Hsuan, Burke William J
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.
Sydney Pharmacy School, University of Sydney, Sydney, Australia.
Neuropsychiatr Dis Treat. 2020 Jun 8;16:1433-1450. doi: 10.2147/NDT.S241749. eCollection 2020.
Little is known about adherence to antidepressant treatment during acute and continuation phase of depression among older adults with dementia and newly diagnosed major depressive disorders (MDD). This study estimated the extent of and factors associated with adherence to acute and continuation phase antidepressant treatment among older adults with dementia and newly diagnosed MDD.
We conducted a retrospective cohort study using the Medicare 5% sample claims data (2012-2013) among older adults (age≥65 years) with dementia who were newly diagnosed with MDD. Intake period of our study was from 01-May-2012 through 30-April-2013. The dependent variables of this study were acute and continuation phase depression treatment adherence. Factors associated with acute and continuation phase antidepressant treatment adherence were identified using multiple logistic regression analyses.
The final study sample consisted of 6239 [adherent: N=4644 (74.44%)] and 5617 [adherent: N=3584 (63.81%)] older adults with dementia and MDD during the acute and continuation phase treatment, respectively. During the acute phase, only race/ethnicity was significantly associated with adherence to depression treatment, whereas race/ethnicity and baseline antipsychotic use were significantly associated with adherence to depression treatment during the continuation phase.
Approximately, 74% and 64% older adults with dementia and MDD were adherent to acute and continuation phase antidepressant treatment in this nationally representative sample of Medicare beneficiaries, and we identified several modifiable and non-modifiable factors associated with adherence.
对于患有痴呆症且新诊断为重度抑郁症（MDD）的老年人，在抑郁症急性期和延续期对抗抑郁药物治疗的依从性了解甚少。本研究估计了患有痴呆症且新诊断为MDD的老年人在急性期和延续期对抗抑郁药物治疗的依从程度及相关因素。
我们使用医疗保险5%样本理赔数据（2012 - 2013年）对年龄≥65岁、新诊断为MDD的痴呆症老年人进行了一项回顾性队列研究。我们研究的纳入期为2012年5月1日至2013年4月30日。本研究的因变量为急性期和延续期抑郁症治疗依从性。使用多元逻辑回归分析确定与急性期和延续期抗抑郁药物治疗依从性相关的因素。
最终研究样本分别包括6239名[依从者：N = 4644（74.44%）]和5617名[依从者：N = 3584（63.81%）]患有痴呆症且MDD的老年人，分别处于急性期和延续期治疗阶段。在急性期，只有种族/民族与抑郁症治疗依从性显著相关，而在延续期，种族/民族和基线抗精神病药物使用与抑郁症治疗依从性显著相关。
在这个具有全国代表性的医疗保险受益人群样本中，约74%和64%患有痴呆症且MDD的老年人在急性期和延续期坚持服用抗抑郁药物，并且我们确定了几个与依从性相关的可改变和不可改变因素。
