PATTERNS AND PREDICTORS OF ANTIDEPRESSANT USE AMONG ADULTS WITH DEPRESSION IN THE UNITED STATES
Author(s)
Samuel C. Ofili, BPharm1, Michael C. Okonkwo, BPharm1, Susan Abughosh, PhD2, Sujit Sansgiry, PhD3;
1University of Houston, Pharmaceutical Outcomes and Policy, Houston, TX, USA, 2University of Houston College of Pharmacy, Pharmaceutical Outcomes and Policy, Houston, TX, USA, 3University of Houston, Houston, TX, USA
1University of Houston, Pharmaceutical Outcomes and Policy, Houston, TX, USA, 2University of Houston College of Pharmacy, Pharmaceutical Outcomes and Policy, Houston, TX, USA, 3University of Houston, Houston, TX, USA
OBJECTIVES: Depression is commonly treated with antidepressants, yet national patterns of use and patient-level predictors remain incompletely characterized. Understanding these patterns is important for informing clinical and public health strategies. This study aimed to examine patterns and predictors of antidepressant use among U.S. adults with depression
METHODS: We conducted a cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) from 2019-2023, including adults diagnosed with depression (ICD-10 F32/F33). Antidepressant use was identified from prescription records. Descriptive analyses compared sociodemographic and clinical characteristics by antidepressant use. Multivariable logistic regression identified independent predictors, adjusting for age, sex, race/ethnicity, education, income, insurance status, perceived health, chronic conditions, obesity, cardiovascular disease, and comorbid anxiety. All analyses accounted for the complex MEPS survey design using sampling weights to ensure national representativeness.
RESULTS: Among 5,531 adults with depression (weighted N=14,861,125), only 1,083 (19.6%; weighted N=2,920,110) used antidepressants. Users were more frequently non-Hispanic White (88% vs. 74%), had private insurance (74% vs. 63%), and had higher incomes compared with non-users. In adjusted analyses, higher educational attainment was associated with increased antidepressant use, with progressively higher odds observed across educational levels compared with no degree. Private insurance increased odds of use (OR=1.47, 95% CI: 1.14-1.90) compared to public insurance. Individuals with 3+ chronic conditions were more likely to use antidepressants (OR=1.47, 95% CI: 1.11-1.94) than those with one or no comorbidities. Individuals reporting excellent (OR=0.56, 95% CI: 0.35-0.90) or good mental health (OR=0.70, 95% CI: 0.50-0.99) were less likely to use antidepressants compared with those reporting poor health.
CONCLUSIONS: Only one-fifth of adults with depression used antidepressants. Higher education, private insurance, and greater comorbidity burden were associated with increased use, whereas better self-perceived health was associated with lower use. Increasing the appropriate use of antidepressants will help many depressed patients improve their health.
METHODS: We conducted a cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) from 2019-2023, including adults diagnosed with depression (ICD-10 F32/F33). Antidepressant use was identified from prescription records. Descriptive analyses compared sociodemographic and clinical characteristics by antidepressant use. Multivariable logistic regression identified independent predictors, adjusting for age, sex, race/ethnicity, education, income, insurance status, perceived health, chronic conditions, obesity, cardiovascular disease, and comorbid anxiety. All analyses accounted for the complex MEPS survey design using sampling weights to ensure national representativeness.
RESULTS: Among 5,531 adults with depression (weighted N=14,861,125), only 1,083 (19.6%; weighted N=2,920,110) used antidepressants. Users were more frequently non-Hispanic White (88% vs. 74%), had private insurance (74% vs. 63%), and had higher incomes compared with non-users. In adjusted analyses, higher educational attainment was associated with increased antidepressant use, with progressively higher odds observed across educational levels compared with no degree. Private insurance increased odds of use (OR=1.47, 95% CI: 1.14-1.90) compared to public insurance. Individuals with 3+ chronic conditions were more likely to use antidepressants (OR=1.47, 95% CI: 1.11-1.94) than those with one or no comorbidities. Individuals reporting excellent (OR=0.56, 95% CI: 0.35-0.90) or good mental health (OR=0.70, 95% CI: 0.50-0.99) were less likely to use antidepressants compared with those reporting poor health.
CONCLUSIONS: Only one-fifth of adults with depression used antidepressants. Higher education, private insurance, and greater comorbidity burden were associated with increased use, whereas better self-perceived health was associated with lower use. Increasing the appropriate use of antidepressants will help many depressed patients improve their health.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD58
Topic
Health Service Delivery & Process of Care