OBJECTIVE: This study described the association of general medical and psychiatric comorbidities with receipt of guideline-concordant depression care. METHODS: Pharmacy, medical, and behavioral claims and enrollment data from OptumHealth in 2003-2006 were linked for 1,835 adults with a new depression diagnosis or a new antidepressant fill. Multiple logistic regression was used to estimate the association of comorbidities with receipt of guideline-concordant pharmacotherapy, guideline-concordant psychotherapy, and any guideline-concordant therapy. RESULTS: Eleven percent of patients received guideline-concordant psychotherapy; 23%, guideline-concordant pharmacotherapy; and 33%, any guideline-concordant therapy. Having a psychiatric but no medical comorbidity was associated with higher rates of guideline-concordant psychotherapy and overall guideline concordance; conversely, having a general medical but no psychiatric comorbidity was associated with lower rates of guideline-concordant psychotherapy. Comorbidities were associated with the probability of receiving any guideline-concordant therapy, but they were not associated with improved guideline concordance among patients already receiving therapy. CONCLUSIONS: Patients with general medical comorbidities may not receive psychotherapy referrals, perhaps because of well-established relationships with their primary care providers.
OBJECTIVE: This study described the association of general medical and psychiatric comorbidities with receipt of guideline-concordant depression care. METHODS: Pharmacy, medical, and behavioral claims and enrollment data from OptumHealth in 2003-2006 were linked for 1,835 adults with a new depression diagnosis or a new antidepressant fill. Multiple logistic regression was used to estimate the association of comorbidities with receipt of guideline-concordant pharmacotherapy, guideline-concordant psychotherapy, and any guideline-concordant therapy. RESULTS: Eleven percent of patients received guideline-concordant psychotherapy; 23%, guideline-concordant pharmacotherapy; and 33%, any guideline-concordant therapy. Having a psychiatric but no medical comorbidity was associated with higher rates of guideline-concordant psychotherapy and overall guideline concordance; conversely, having a general medical but no psychiatric comorbidity was associated with lower rates of guideline-concordant psychotherapy. Comorbidities were associated with the probability of receiving any guideline-concordant therapy, but they were not associated with improved guideline concordance among patients already receiving therapy. CONCLUSIONS:Patients with general medical comorbidities may not receive psychotherapy referrals, perhaps because of well-established relationships with their primary care providers.
Authors: Karen E Swietek; Marisa Elena Domino; Lexie R Grove; Chris Beadles; Alan R Ellis; Joel F Farley; Carlos Jackson; Jesse C Lichstein; C Annette DuBard Journal: Health Serv Res Date: 2021-08-17 Impact factor: 3.734
Authors: Hsiang Huang; Joan Russo; Amy M Bauer; Ya-Fen Chan; Wayne Katon; Diane Hogan; Jürgen Unützer Journal: Gen Hosp Psychiatry Date: 2013-04-01 Impact factor: 3.238
Authors: Rebecca Strawbridge; Paul McCrone; Andrea Ulrichsen; Roland Zahn; Jonas Eberhard; Danuta Wasserman; Paolo Brambilla; Giandomenico Schiena; Ulrich Hegerl; Judit Balazs; Jose Caldas de Almeida; Ana Antunes; Spyridon Baltzis; Vladimir Carli; Vinciane Quoidbach; Patrice Boyer; Allan H Young Journal: Eur Psychiatry Date: 2022-06-15 Impact factor: 7.156