Division of Epidemiology Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152, USA.
Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN 38152, USA.
Int J Environ Res Public Health. 2024 Sep 13;21(9):1209. doi: 10.3390/ijerph21091209.
Antidepressants are among the most prescribed drugs in the US, but the current treatment patterns and modalities among older adults are unclear. This study assessed the patterns of discontinuation of antidepressants and the risk of medication resumption among community-dwelling older adults with depression. Using Medicare Current Beneficiary Survey (MCBS) data from 2015-2019, we identified 1084 beneficiaries with depression who newly initiated serotonergic antidepressants. The risk of medication resumption was explored using survival analysis. The median duration of continuous medication was 90 days. However, about 30% of patients had a treatment duration of 30 days or shorter, 26% for 31-90 days, 15% for 91-180 days, and 30% for 181 days or more. After adjusting for all covariates, patients with less than 30 days of continuous medication were half as likely to resume the medications compared to those with 91-180 days (HR: 0.49 (95% CI: 0.37, 0.65)). Nearly one-third of older adults used an antidepressant medication for a short duration with a lower risk of medication resumption. A shorter treatment duration without resumption might suggest over-prescription of antidepressants among community-dwelling older adults.
抗抑郁药是美国最常开的药物之一，但目前老年人的治疗模式和方式尚不清楚。本研究评估了社区居住的抑郁症老年患者中断抗抑郁药治疗和重新开始药物治疗的模式。使用 2015-2019 年医疗保险当前受益人调查（MCBS）数据，我们确定了 1084 名新开始使用 5-羟色胺能抗抑郁药的抑郁症受益人。使用生存分析探讨了药物重新开始的风险。连续用药的中位持续时间为 90 天。然而，约 30%的患者治疗持续时间为 30 天或更短，26%为 31-90 天，15%为 91-180 天，30%为 181 天或更长。在调整了所有协变量后，与连续用药 91-180 天的患者相比，连续用药不足 30 天的患者重新开始用药的可能性降低一半（HR：0.49（95%CI：0.37，0.65））。近三分之一的老年人使用抗抑郁药物的持续时间较短，重新开始药物治疗的风险较低。没有重新开始治疗的较短治疗持续时间可能表明社区居住的老年人抗抑郁药的过度处方。
