TREATMENT PATTERNS OF DEPRESSION AMONG NON-INSTITUTIONALIZED CANCER SURVIVORS IN THE UNITED STATES

Author(s)

Kale HP, Varghese D, Carroll NV
Virginia Commonwealth University, Richmond, VA, USA

OBJECTIVES: Depression among cancer survivors (CS) is associated with elevated risk of suicide, poor quality of life, and increased risk of mortality. Antidepressants and/or psychotherapy can be given to manage depression among CS. This study describes patterns and determines predictors of depression treatment among non-institutionalized CS. METHODS: This is a cross sectional study using 2008-2012 Medical Expenditure Panel Survey (MEPS) data. From all CS, we identified depression cases using ICD9-CM codes: 296 & 311. Multivariable binary and multinomial logistic regression models were used to assess predictors for any depression treatment (psychotherapy and/or antidepressants), antidepressant only, and combination therapy (antidepressant + psychotherapy) vs. no treatment. The Andersen Behavioral Model was used to select and categorize predictors into pre-disposing, enablingand need factors. All analyses were weighted to get national estimates and accounted for MEPS’s complex survey design. RESULTS: Of 24.3 million CS, 15% were diagnosed with depression. Among them, 19% received no treatment, 68% received only antidepressants, and 13% received combination therapy. Selective serotonin reuptake inhibitors (53%) and serotonin norepinephrine reuptake inhibitors (20%) were the most frequently prescribed antidepressant classes. Significant predictors (p <0.05) for any depression treatment were females (OR = 1.84), Hispanics (OR = 0.46), private (OR= 2.77) or public (OR = 2.68) insurance, usual source of care (OR = 3.26), and depressed mood (OR = 1.71). Similar factors predicted antidepressant use without psychotherapy. In addition to the aforementioned predictors, age <65 years (OR = 0.44), >high school education (OR = 2.08), and living in the South (OR = 0.38) were significant predictors for combination therapy.  CONCLUSIONS: Being female or Hispanic, having access to health insurance and usual source of care, and presence of depressed mood were determinants of receiving treatment for depression. Younger age and having more than high school education were significantly associated with combination therapy.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PCN39

Topic

Epidemiology & Public Health

Topic Subcategory

Safety & Pharmacoepidemiology

Disease

Mental Health, Oncology

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