RT Journal Article
SR Electronic
T1 Factors associated with duration of new antidepressant treatment: analysis of a large primary care database
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e104
OP e112
DO 10.3399/bjgp12X625166
VO 62
IS 595
A1 Christopher Burton
A1 Niall Anderson
A1 Katie Wilde
A1 Colin R Simpson
YR 2012
UL http://bjgp.org/content/62/595/e104.abstract
AB Background It is not known how much the duration of newly prescribed antidepressant treatment is influenced by patient characteristics or practice variation.Aim To describe the relationship between patient characteristics and the duration of new antidepressant treatment by general practices.Design and setting Large primary care database cohort study of all patients with a newly initiated course of eligible antidepressant treatment during 1 year, from a database of 237 Scottish practices.Method Detailed prescription data were used to estimate the duration of new antidepressant treatment for each patient. Cox proportional hazards regression was used to estimate the influence of patient characteristics on continuation of treatment and, by multilevel modelling, the variation between practices.Results A total of 28 027 (2.2%) patients commenced antidepressant treatment during the year; 75% continued beyond 30 days, 56% beyond 90 days, and 40% beyond 180 days. Treatment was less likely to be continued in patients from areas of high socioeconomic deprivation: hazard ratio 1.22 (95% confidence interval [CI] = 1.16 to 1.29); in patients under 35 years, 1.33 (95% CI = 1.28 to 1.37); and in those for whom the GP recorded no relevant diagnostic code, 1.16 (95% CI = 1.13 to 1.18). Models accounted for between 2.2% and 3.9% of the variation in treatment duration.Conclusion Patient demographic characteristics account for relatively little variation in the duration of new antidepressant treatment, though treatment was shorter in younger patients and those with greater socioeconomic deprivation. There is variation in treatment duration between practices and according to whether patients have a depression diagnosis coded in their records.