Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Guideline-concordant antidepressant use among patients with major depressive disorder.

Chen SY, Hansen RA, Gaynes BN, Farley JF, Morrissey JP, Maciejewski ML. Guideline-concordant antidepressant use among patients with major depressive disorder. General hospital psychiatry. 2010 Jul 1; 32(4):360-7.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


OBJECTIVES: To examine whether prescriber specialty and guideline-concordant follow-up visits were associated with antidepressant treatment completion among patients with major depressive disorder (MDD). METHODS: This study analyzed medical and prescription claims from a large national health plan. Patients were grouped based on initial prescriber specialty. Receipt of guideline-concordant follow-ups was defined as having > or = 3 visits during the treatment phase. Completion of acute phase (first 90 days) and continuation phase (Days 91-270) was defined by adherence > or = 80% without significant gaps in treatment. Logistic regressions were used to examine factors associated with treatment completion. RESULTS: Forty-seven percent of the 4102 newly diagnosed patients completed the acute phase, 45% of whom also completed the continuation phase. Among those initially prescribed by primary care providers (PCPs), patients with guideline-concordant follow-ups were more likely (13.1 percentage points, P < .0001) to complete acute phase than patients without guideline-concordant follow-ups. Receipt of guideline-concordant follow-ups increased the probability of acute phase completion by an additional 6.8 percentage points if initially treated by psychiatrists. Patients prescribed by psychiatrists were less likely to complete acute phase treatment (-4.6 percentage points, P = .04) if they did not have guideline-concordant follow-ups. CONCLUSION: A large gap remains between guideline recommendations and actual antidepressant treatment. Frequent follow-up corresponds with better antidepressant adherence.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.