Discontinuation of Antidepressants and the Risk of Medication Resumption among Community-Dwelling Older Adults with Depression in the US

3区综合性期刊 Q1 Medicine

International Journal of Environmental Research and Public Health Pub Date : 2024-09-13 DOI:10.3390/ijerph21091209

Easter P. Gain, Xinhua Yu, Satish K. Kedia, Abu Mohd Naser, Morgan I. Bromley, Mark’Quest Ajoku, Xichen Mou

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引用次数: 0

Abstract

Antidepressants are among the most prescribed drugs in the US, but the current treatment patterns and modalities among older adults are unclear. This study assessed the patterns of discontinuation of antidepressants and the risk of medication resumption among community-dwelling older adults with depression. Using Medicare Current Beneficiary Survey (MCBS) data from 2015–2019, we identified 1084 beneficiaries with depression who newly initiated serotonergic antidepressants. The risk of medication resumption was explored using survival analysis. The median duration of continuous medication was 90 days. However, about 30% of patients had a treatment duration of 30 days or shorter, 26% for 31–90 days, 15% for 91–180 days, and 30% for 181 days or more. After adjusting for all covariates, patients with less than 30 days of continuous medication were half as likely to resume the medications compared to those with 91–180 days (HR: 0.49 (95% CI: 0.37, 0.65)). Nearly one-third of older adults used an antidepressant medication for a short duration with a lower risk of medication resumption. A shorter treatment duration without resumption might suggest over-prescription of antidepressants among community-dwelling older adults.

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美国社区居住的老年抑郁症患者停用抗抑郁药与复药风险

抗抑郁药是美国处方量最大的药物之一，但目前老年人的治疗模式和方式尚不明确。本研究评估了居住在社区的老年抑郁症患者停用抗抑郁药的模式和复药风险。利用 2015-2019 年的医疗保险当前受益人调查（MCBS）数据，我们确定了 1084 名新开始服用血清素能抗抑郁药的抑郁症受益人。通过生存分析探讨了恢复用药的风险。连续用药时间的中位数为 90 天。然而，约 30% 的患者的治疗时间为 30 天或更短，26% 为 31-90 天，15% 为 91-180 天，30% 为 181 天或更长。在对所有协变量进行调整后，连续服药时间少于 30 天的患者与 91-180 天的患者相比，恢复服药的可能性降低了一半（HR：0.49（95% CI：0.37，0.65））。近三分之一的老年人使用抗抑郁药物的时间较短，恢复用药的风险较低。治疗时间较短而未恢复用药可能表明，社区居住的老年人过度开具了抗抑郁药物处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Environmental Research and Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

7.30

自引率

0.00%

发文量

14422

审稿时长

1 months

期刊介绍： International Journal of Environmental Research and Public Health (IJERPH) (ISSN 1660-4601) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes, and short communications in the interdisciplinary area of environmental health sciences and public health. It links several scientific disciplines including biology, biochemistry, biotechnology, cellular and molecular biology, chemistry, computer science, ecology, engineering, epidemiology, genetics, immunology, microbiology, oncology, pathology, pharmacology, and toxicology, in an integrated fashion, to address critical issues related to environmental quality and public health. Therefore, IJERPH focuses on the publication of scientific and technical information on the impacts of natural phenomena and anthropogenic factors on the quality of our environment, the interrelationships between environmental health and the quality of life, as well as the socio-cultural, political, economic, and legal considerations related to environmental stewardship and public health. The 2018 IJERPH Outstanding Reviewer Award has been launched! This award acknowledge those who have generously dedicated their time to review manuscripts submitted to IJERPH. See full details at http://www.mdpi.com/journal/ijerph/awards.