Treatment of depression in older primary care patients in health maintenance organizations.
To examine whether older HMO patients with depression are treated differently than younger patients in terms of diagnosis, treatment by specialty provider, and pharmacotherapy.
Chart-review, Cross sectional study.
Settings and Participants
Patients were selected from six HMOs in the United States who had one or more of five medical diagnoses : arthritis, asthma, otitis media, epigastric pain/ulcer, and hypertension, (n=9143).
From this group, chart diagnoses and pharmacy records were used to identify patients who also had a diagnosis of depression (n=416) or who had a diagnosis of depression and/or treatment with antidepressant medication (n=1286).
Medical records and computerized service and pharmacy records were reviewed to obtain diagnoses, office visits by provider type, and psychiatric medication prescription counts.
Significant differences were found in treatment of depression for older versus younger patients.
Although depression was identified at a similar rate for both groups, older patients received fewer mental health specialty visits and fewer prescriptions for SSRI antidepressants.
Older patients with a diagnosis of depression were more likely to be treated with benzodiazepines (49.2% of older vs. 33.2% if younger) though they were less likely to receive long half-life benzodiazepines. (...)
Mots-clés Pascal : Etat dépressif, Soin santé primaire, Traitement, Chimiothérapie, Psychotrope, Antidépresseur, Prescription médicale, Service santé, Soin intégré, Vieillard, Homme, Trouble humeur
Mots-clés Pascal anglais : Depression, Primary health care, Treatment, Chemotherapy, Psychotropic, Antidepressant agent, Medical prescription, Health service, Managed care, Elderly, Human, Mood disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0102048
Code Inist : 002B18E. Création : 22/06/1998.