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Persistence with Newly Initiated Antidepressant Medication in Rhode Island Medicaid: Analysis and Insights for
Stephen Kogut1, Brian J Quilliam2, Rita Marcoux3
1Professor of Pharmacy Practice, Program in Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Rhode Island, Kingston, RI.
Objective:
To describe persistence to newly prescribed antidepressant medications within the Rhode Island Medicaid population.
Methods:
This retrospective study analyzed antidepressant medication persistence in a cohort of new users for a period spanning 2013-2014, focusing on the acute treatment phase (first 12 weeks of treatment). Covariates assessed included patient gender, age, comorbidity status, and measures of health system utilization.
Results:
Only 53.8% of patients persisted with medication for at least 12 weeks. (Figure 1). Persistence was increased with age > 35, and lower among patients lacking a follow-up visit. Multivariable analyses revealed that patients having at least one office visit during the follow-up period were nearly 2.5 times more likely to persist as compared to patients lacking such visits (OR 2.44, 95% CI 1.77-3.35). Persistence was 22% more likely among patients receiving psychiatric services (OR 1.22; 95% CI 1.00-1.48).
Conclusions:
Antidepressant treatment persistence within the R.I. Medicaid population is suboptimal, and lowest among patients lacking follow-up care.
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