Restarting antidepressant treatment following early discontinuation

a primary care database study

Research output: Contribution to journalArticle

5 Citations (Scopus)
4 Downloads (Pure)

Abstract

Background

Many patients in primary care stop antidepressant treatment after only one prescription, so do not benefit from treatment. Some patients who stop initial antidepressant treatment go on to restart it, but neither the incidence of restarting, nor the probability that patients who restart treatment subsequently complete an adequate course of treatment is known.

Methods

We used a primary care database (over 1.2 million records) to study patients who commenced treatment with an eligible antidepressant between April 2007 and March 2008 and who stopped treatment for at least one month after the first prescription. We examined their subsequent antidepressant prescriptions to estimate the probability of restarting antidepressant treatment, the likelihood of continuing subsequent treatment, and the patient characteristics associated with these.

Results

6,952/24,817 (28%) patients discontinued antidepressant treatment after the first prescription. The cumulative probability of restarting treatment after early discontinuation was 8.6% (95% ci 8.0 - 9.3) after one month off treatment, and 24.1% (22.9 - 25.2) after 9 months off treatment. The probability of those who restarted treatment continuing for 6 months or more was 29.3% (26.5 -32.5).

Conclusions

Few patients who stop antidepressant treatment after the first prescription subsequently complete an adequate treatment course within the next year. Initiatives to promote adherence to appropriate antidepressant treatment should begin during the first prescription.
Original languageEnglish
Pages (from-to)520-524
Number of pages5
JournalFamily Practice
Volume32
Issue number5
Early online date5 Aug 2015
DOIs
Publication statusPublished - Oct 2015

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Antidepressive Agents
Primary Health Care
Databases
Prescriptions
Therapeutics

Keywords

  • antidepressant treatment
  • database research
  • depression
  • prescribing
  • primary care

Cite this

Restarting antidepressant treatment following early discontinuation : a primary care database study. / Burton, Christopher; Cochran, Amanda J; Cameron, Isobel M.

In: Family Practice, Vol. 32, No. 5, 10.2015, p. 520-524.

Research output: Contribution to journalArticle

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title = "Restarting antidepressant treatment following early discontinuation: a primary care database study",
abstract = "BackgroundMany patients in primary care stop antidepressant treatment after only one prescription, so do not benefit from treatment. Some patients who stop initial antidepressant treatment go on to restart it, but neither the incidence of restarting, nor the probability that patients who restart treatment subsequently complete an adequate course of treatment is known.MethodsWe used a primary care database (over 1.2 million records) to study patients who commenced treatment with an eligible antidepressant between April 2007 and March 2008 and who stopped treatment for at least one month after the first prescription. We examined their subsequent antidepressant prescriptions to estimate the probability of restarting antidepressant treatment, the likelihood of continuing subsequent treatment, and the patient characteristics associated with these.Results6,952/24,817 (28{\%}) patients discontinued antidepressant treatment after the first prescription. The cumulative probability of restarting treatment after early discontinuation was 8.6{\%} (95{\%} ci 8.0 - 9.3) after one month off treatment, and 24.1{\%} (22.9 - 25.2) after 9 months off treatment. The probability of those who restarted treatment continuing for 6 months or more was 29.3{\%} (26.5 -32.5).ConclusionsFew patients who stop antidepressant treatment after the first prescription subsequently complete an adequate treatment course within the next year. Initiatives to promote adherence to appropriate antidepressant treatment should begin during the first prescription.",
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N2 - BackgroundMany patients in primary care stop antidepressant treatment after only one prescription, so do not benefit from treatment. Some patients who stop initial antidepressant treatment go on to restart it, but neither the incidence of restarting, nor the probability that patients who restart treatment subsequently complete an adequate course of treatment is known.MethodsWe used a primary care database (over 1.2 million records) to study patients who commenced treatment with an eligible antidepressant between April 2007 and March 2008 and who stopped treatment for at least one month after the first prescription. We examined their subsequent antidepressant prescriptions to estimate the probability of restarting antidepressant treatment, the likelihood of continuing subsequent treatment, and the patient characteristics associated with these.Results6,952/24,817 (28%) patients discontinued antidepressant treatment after the first prescription. The cumulative probability of restarting treatment after early discontinuation was 8.6% (95% ci 8.0 - 9.3) after one month off treatment, and 24.1% (22.9 - 25.2) after 9 months off treatment. The probability of those who restarted treatment continuing for 6 months or more was 29.3% (26.5 -32.5).ConclusionsFew patients who stop antidepressant treatment after the first prescription subsequently complete an adequate treatment course within the next year. Initiatives to promote adherence to appropriate antidepressant treatment should begin during the first prescription.

AB - BackgroundMany patients in primary care stop antidepressant treatment after only one prescription, so do not benefit from treatment. Some patients who stop initial antidepressant treatment go on to restart it, but neither the incidence of restarting, nor the probability that patients who restart treatment subsequently complete an adequate course of treatment is known.MethodsWe used a primary care database (over 1.2 million records) to study patients who commenced treatment with an eligible antidepressant between April 2007 and March 2008 and who stopped treatment for at least one month after the first prescription. We examined their subsequent antidepressant prescriptions to estimate the probability of restarting antidepressant treatment, the likelihood of continuing subsequent treatment, and the patient characteristics associated with these.Results6,952/24,817 (28%) patients discontinued antidepressant treatment after the first prescription. The cumulative probability of restarting treatment after early discontinuation was 8.6% (95% ci 8.0 - 9.3) after one month off treatment, and 24.1% (22.9 - 25.2) after 9 months off treatment. The probability of those who restarted treatment continuing for 6 months or more was 29.3% (26.5 -32.5).ConclusionsFew patients who stop antidepressant treatment after the first prescription subsequently complete an adequate treatment course within the next year. Initiatives to promote adherence to appropriate antidepressant treatment should begin during the first prescription.

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