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A pilot study to describe antidepressant prescriptions dispensed to veterans after stroke
L Douglas Ried1, Michael J Tueth, Huangang Jia
1Rehabilitation Outcomes Research Center (151B), Malcom Randall Veterans Affairs Medical Center, Gainesville, FL 32608-1197, USA. doug.ried@med.va.gov
Insights
Veterans receiving antidepressants after a stroke showed improved survival rates. Early antidepressant treatment may reduce post-stroke mortality and improve recovery outcomes.
Area of Science:
- Neurology
- Psychiatry
- Public Health
Background:
- Stroke is a leading cause of death in the US, with 500,000 cases annually.
- Post-stroke depression is linked to increased mortality, morbidity, and slower recovery.
- Early antidepressant intervention may benefit depressed stroke patients.
Purpose of the Study:
- To analyze antidepressant dispensing patterns in veteran patients before and after stroke.
- To investigate the association between post-stroke antidepressant treatment and mortality.
Main Methods:
- Identified 543 veteran patients hospitalized for stroke in FY2001.
- Utilized the Veterans Integrated System Network 8 VA Pharmacy Benefits Management database for dispensing records.
- Examined antidepressant prescriptions dispensed within a 6-month pre-stroke period and a 1-year post-stroke period.
Main Results:
- One-third of eligible veterans received antidepressants before or after hospitalization (n=181).
- 146 veterans were dispensed antidepressants after their stroke.
- Veterans receiving antidepressants post-stroke had a lower 1-year all-cause mortality rate (4.8%) compared to those without (8.0%).
Conclusions:
- Post-stroke antidepressant treatment appears beneficial for veterans.
- Timely antidepressant use may mitigate stroke consequences and enhance recovery.
- Missed opportunities for intervention could negatively impact patient outcomes.
Background:
Stroke is the third leading cause of death in the United States, following only heart disease and cancer. Approximately 500,000 strokes occur each year in the United States. Patients suffering from poststroke depression have higher rates of morbidity and mortality, slower physical recovery, and lower functional status than stroke patients without depression. Depressed stroke patients may benefit from early treatment with an antidepressant.
Objectives:
The objectives of this study were to (1) describe antidepressant-dispensing patterns to veteran patients during the 6-month period before their stroke and 1-year time afterward and (2) examine the association of poststroke antidepressant treatment with mortality.
Methods:
Veteran patients (n=543) with one or more hospital discharges during FY2001 with a primary diagnosis of stroke were identified. The discharge date minus the length of stay indicated the index hospitalization date. Antidepressant prescription dispensing records were obtained from the Veterans Integrated System Network 8 Veteran's Affairs (VA) Pharmacy Benefits Management database.
Results:
One-third of eligible veteran patients were dispensed one or more antidepressant prescriptions (n=181) either before or after the index hospitalization. Of these veterans, 146 received an antidepressant after the index hospitalization. More than 80% of veteran patients survived the stroke for 1 year or longer (n=448). Among the veteran patients who were discharged from the index hospitalization alive, those with no antidepressant or an antidepressant dispensed only before the stroke had a higher 1 year all cause mortality rate (8.0%) compared with those who were dispensed a prescription for one or more antidepressants afterward (4.8%).
Conclusions:
Veterans dispensed an antidepressant after their stroke appeared to have benefited. Opportunities to reduce poststroke sequelae and improve recovery may be lost.
