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Depression diagnoses and antidepressant use in primary care practices: a study from the Practice Partner Research
S Ornstein1, G Stuart, R Jenkins
1Department of Family Medicine and the Center for Health Care Research, Medical University of South Carolina, Charleston, USA.
The Journal of Family Practice
|February 26, 2000
Summary
Primary care physicians frequently diagnose depression and prescribe antidepressants, with significant practice variations. While follow-up care is common, opportunities exist to improve depression detection and treatment.
Area of Science:
- Primary Care Medicine
- Psychiatry
- Health Services Research
Background:
- Examined pharmacologic management and follow-up for adults with newly diagnosed depression in primary care.
- Investigated antidepressant use in patients without a depression diagnosis.
Purpose of the Study:
- To assess the diagnosis and treatment patterns of depression in primary care settings.
- To understand antidepressant prescribing practices, including off-label use.
Main Methods:
- Retrospective cohort study using electronic medical record data from 39 primary care practices (1996 data).
- Identified new depression diagnoses, antidepressant prescriptions within 5 days, and follow-up contacts within 6 months.
- Analyzed prescription data for patients without a depression diagnosis.
Main Results:
- 1.6% of eligible patients received a new depression diagnosis (incidence varied by practice).
- 49% of newly diagnosed patients received antidepressants within 5 days, predominantly Selective Serotonin Reuptake Inhibitors (SSRIs).
- 6.3% of all patients received an antidepressant prescription; over 40% lacked a depression diagnosis.
Conclusions:
- Significant inter-practice variation exists in diagnosing depression and prescribing antidepressants.
- Follow-up care for newly diagnosed depression was generally consistent with guidelines.
- Opportunities identified for enhancing depression detection and treatment in primary care.