Abstracts
3427218
(#32) Gaps in Treatment Continuity in Major Depressive Disorder: Variation by Healthcare Provider Specialty and Treatment Sequence
Abstract: Introduction: Many people with major depressive disorder (MDD) have an inadequate response to current pharmacological treatments, often resulting in frequent changes and/or discontinuation of treatment. Understanding variation in treatment continuity across healthcare provider (HCP) types and lines of therapy (LOT) is essential to optimizing care.
Methods: A retrospective observational study was conducted using electronic health records (EHR) data linked to closed claims; adults with a new MDD diagnosis were included. LOTs were defined based on changes in antidepressant treatment. Adherence was defined as the number of days' supply of medication divided by the total days in the follow-up period; persistence was defined as the number of days from the first prescription fill to the last day of medication supply; and discontinuation was defined as a gap of ≥45 days without medication supply.
Results: Mean adherence during the variable-length follow-up was 0.44 regardless of HCP type at diagnosis. Mean persistence was 285 days among patients diagnosed by primary care physicians, 278 days among psychiatrists and nurse practitioners, and 271 days among physician associates/assistants (PAs). Discontinuation of first-line treatment ranged from 31-33% across HCP types. Adherence improved during the third and fourth LOTs (0.63-0.69) but declined again in subsequent LOTs, particularly among patients diagnosed by PAs (~0.44)
Conclusion: Declining adherence in later LOTs across all HCP types underscores the need for more effective and well-tolerated treatments in MDD, as well as the importance of selecting treatments with an optimal efficacy/safety balance to improve long-term patient outcomes.
Short Description: A retrospective observational study was conducted to assess the antidepressant adherence, persistence, and discontinuation among adults with newly diagnosed MDD using linked EHR and claims data. Adherence to MDD treatments was low regardless of the HCP type at diagnosis. Persistence varied by diagnosing HCP type, particularly showing decline in later lines, indicating the need for more effective, well-tolerated MDD treatments to help improve patient outcomes.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
Methods: A retrospective observational study was conducted using electronic health records (EHR) data linked to closed claims; adults with a new MDD diagnosis were included. LOTs were defined based on changes in antidepressant treatment. Adherence was defined as the number of days' supply of medication divided by the total days in the follow-up period; persistence was defined as the number of days from the first prescription fill to the last day of medication supply; and discontinuation was defined as a gap of ≥45 days without medication supply.
Results: Mean adherence during the variable-length follow-up was 0.44 regardless of HCP type at diagnosis. Mean persistence was 285 days among patients diagnosed by primary care physicians, 278 days among psychiatrists and nurse practitioners, and 271 days among physician associates/assistants (PAs). Discontinuation of first-line treatment ranged from 31-33% across HCP types. Adherence improved during the third and fourth LOTs (0.63-0.69) but declined again in subsequent LOTs, particularly among patients diagnosed by PAs (~0.44)
Conclusion: Declining adherence in later LOTs across all HCP types underscores the need for more effective and well-tolerated treatments in MDD, as well as the importance of selecting treatments with an optimal efficacy/safety balance to improve long-term patient outcomes.
Short Description: A retrospective observational study was conducted to assess the antidepressant adherence, persistence, and discontinuation among adults with newly diagnosed MDD using linked EHR and claims data. Adherence to MDD treatments was low regardless of the HCP type at diagnosis. Persistence varied by diagnosing HCP type, particularly showing decline in later lines, indicating the need for more effective, well-tolerated MDD treatments to help improve patient outcomes.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
