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  1. Treatment of depression in older primary care patients in health maintenance organizations.

    Article - En anglais

    Objective 

    To examine whether older HMO patients with depression are treated differently than younger patients in terms of diagnosis, treatment by specialty provider, and pharmacotherapy.

    Design 

    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).

    Measurements 

    Medical records and computerized service and pharmacy records were reviewed to obtain diagnoses, office visits by provider type, and psychiatric medication prescription counts.

    Results 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0102048

    Code Inist : 002B18E. Création : 22/06/1998.