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Relationship between antidepressant medication possession and treatment response
John C Fortney1, Jeffrey M Pyne, Mark J Edlund
1VA South Central Mental Illness Education and Clinic Center (MIRECC), Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA. fortneyjohnc@uams.edu
General Hospital Psychiatry
|July 17, 2010
Summary
High antidepressant medication possession ratios (MPR) significantly correlate with improved depression symptom treatment response. This finding suggests MPR can estimate treatment effectiveness when direct symptom data is unavailable.
Area of Science:
- Clinical Pharmacy
- Psychiatry
- Health Services Research
Background:
- Assessing patient adherence to antidepressant medication is crucial for treatment success.
- Medication Possession Ratio (MPR) from administrative data offers a potential proxy for adherence.
Purpose of the Study:
- To determine the correlation between MPR derived from pharmacy data and changes in self-reported depression symptoms.
- To evaluate MPR as a predictor of treatment response in primary care patients.
Main Methods:
- 360 primary care patients in a VA collaborative care trial were analyzed.
- Treatment response defined as 50% symptom improvement (SCL-20) at 6 months.
- Logistic regression assessed MPR association with treatment response, controlling for covariates.
Main Results:
- 70% of patients filled antidepressant prescriptions; average MPR was 0.46.
- 19.2% of patients achieved treatment response.
- MPR >= 0.9 significantly correlated with treatment response (OR=2.43, P=.006).
Conclusions:
- Antidepressant MPR shows predictive validity for treatment response in this cohort.
- MPR may serve as a tool to evaluate treatment effectiveness when symptom data collection is challenging.
- This approach could facilitate routine, system-level evaluation of quality improvement programs for antidepressant adherence.
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