Abstracts
3427216
(#34) Variation in Antidepressant Treatment Patterns across Healthcare Provider Types: A Real-World Analysis
Abstract: Introduction: Real-world management of major depressive disorder (MDD) occurs in a variety of healthcare provider (HCP) settings. Types of HCPs diagnosing MDD, and treatment sequencing by HCP type remain largely underreported. This study characterized real-world antidepressant treatment patterns by HCP type and line of therapy (LOT).
Methods: A retrospective observational approach using electronic health records data linked to closed claims was employed. Adults with a new MDD diagnosis were included; 12 months baseline and ≥6 months follow-up continuous enrollment were required. LOTs were defined based on changes in antidepressant treatment, including switches, and/or initiation of adjunctive treatment.
Results: 189,385 adults with MDD (mean age 45.5 years) met the eligibility criteria. Of the patients diagnosed with MDD, 54.5% were initiated on pharmacological treatment. Primary care providers (PCPs), nurse practitioners (NPs), and physician associates/assistants (PAs) accounted for >50% of the initial MDD diagnoses. Treatment initiation was higher among patients diagnosed by psychiatrists (69.3%), PAs (68.7%), NPs (67.9%), and PCPs (64.2%) than other HCP types. Mean time to MDD treatment initiation was the shortest for psychiatrists, NPs, and PAs (~75 days) and longer for PCPs (95 days). Patients diagnosed by psychiatrists had the shortest time to combination treatment initiation (132 days).
Conclusion: PCPs, NPs, and PAs play a key role in the initial diagnosis and management of MDD. Observed delays and gaps in pharmacologic treatment suggest opportunities for supporting timely treatment initiation, strengthening care coordination across settings and optimizing the use of effective treatment strategies to improve the real-world management of MDD.
Short Description: This retrospective study evaluated real-world antidepressant treatment patterns in adults with newly diagnosed MDD using linked electronic health records and claims data. Over half of initial MDD diagnoses were made by PCPs, NPs, and PAs. Observed delays and gaps in pharmacologic treatment suggest the need for strengthening care coordination across HCP settings, improving timely treatment initiation and optimizing the use of effective treatment strategies to help address gaps in the real-world MDD management.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
Methods: A retrospective observational approach using electronic health records data linked to closed claims was employed. Adults with a new MDD diagnosis were included; 12 months baseline and ≥6 months follow-up continuous enrollment were required. LOTs were defined based on changes in antidepressant treatment, including switches, and/or initiation of adjunctive treatment.
Results: 189,385 adults with MDD (mean age 45.5 years) met the eligibility criteria. Of the patients diagnosed with MDD, 54.5% were initiated on pharmacological treatment. Primary care providers (PCPs), nurse practitioners (NPs), and physician associates/assistants (PAs) accounted for >50% of the initial MDD diagnoses. Treatment initiation was higher among patients diagnosed by psychiatrists (69.3%), PAs (68.7%), NPs (67.9%), and PCPs (64.2%) than other HCP types. Mean time to MDD treatment initiation was the shortest for psychiatrists, NPs, and PAs (~75 days) and longer for PCPs (95 days). Patients diagnosed by psychiatrists had the shortest time to combination treatment initiation (132 days).
Conclusion: PCPs, NPs, and PAs play a key role in the initial diagnosis and management of MDD. Observed delays and gaps in pharmacologic treatment suggest opportunities for supporting timely treatment initiation, strengthening care coordination across settings and optimizing the use of effective treatment strategies to improve the real-world management of MDD.
Short Description: This retrospective study evaluated real-world antidepressant treatment patterns in adults with newly diagnosed MDD using linked electronic health records and claims data. Over half of initial MDD diagnoses were made by PCPs, NPs, and PAs. Observed delays and gaps in pharmacologic treatment suggest the need for strengthening care coordination across HCP settings, improving timely treatment initiation and optimizing the use of effective treatment strategies to help address gaps in the real-world MDD management.
Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.
