ASSOCIATION OF PATIENT CHARACTERISTICS WITH THE USE OF PHARMACOTHERAPY, PSYCHOTHERAPY AND COMBINED TREATMENT FOR DEPRESSION
Author(s)
Luthra R, Li C, Helm ME, Said QUniversity of Arkansas for Medical Sciences, Little Rock, AR, USA
OBJECTIVES: To examine the association of patient characteristics including age, sex, race, geographic diversity, income status, insurance type, perceived mental health status, perceived health status, and co-morbidities of depression with the use of pharmacotherapy, psychotherapy and combined treatment for depression. METHODS: Depressed individuals in the age group 18-65 were identified from the Medical Expenditure Panel Survey 1998-2006. Pregnant women and individuals with other mental health illnesses were excluded. Individuals with at least four antidepressant prescriptions yearly without any psychotherapy formed the pharmacotherapy group. Individuals with at least four psychotherapy visits yearly and no antidepressants formed the psychotherapy group. Combined therapy group included individuals with at least four psychotherapy visits and four antidepressants yearly. Survey weights were applied to get national estimates. RESULTS: There were estimated 1,115,091 patients in the combined group, 3,173,122 in the pharmacotherapy group and 733,264 in the psychotherapy group. Patients in the group 46-65 years were 88% (p=0.000) more likely to get pharmacotherapy than combined therapy, and 45% (p=0.007) less likely to get psychotherapy compared to patients in the age group 18-30. Patients not living in a Metropolitan Statistical Area (MSA) were 80% (p<0.000) more likely to receive pharmacotherapy than combined therapy, compared to patients living in MSA. Patients other than white and black have 85% (p=0.040) higher likelihood of receiving psychotherapy than the combined therapy compared with whites. Patients with self-reported fair or poor physical health were 70% (p=0.002) less likely to receive psychotherapy than combined therapy, compared to those reporting excellent health. Self-reported poor mental health predicts higher likelihood of receiving combined therapy than pharmacotherapy or psychotherapy alone (p<0.000). CONCLUSIONS: There are significant differences among the three treatment groups based on their demographic characteristics. Age, region, perceived overall health status and perceived mental health status were significant predictors of treatment received by the patients.
Conference/Value in Health Info
2010-05, ISPOR 2010, Atlanta, GA, USA
Value in Health, Vol. 13, No. 3 (May 2010)
Code
PMH88
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Mental Health