Despite the availability of effective treatments for depression, many newly diagnosed individuals do not initiate treatment in the 3 months following diagnosis. The findings come from a new observational study published in the Journal of General Internal Medicine.
The study included patients (n=241,251) who were newly diagnosed with depression (defined as ICD-9 codes for depression, after 365 days with no depression diagnosis or treatment) in a primary care setting. The researchers defined treatment initiation as those who had completed a psychotherapy visit or filled a prescription for antidepressant medication within 90 days of diagnosis.
They found that only 35.7% of individuals initiated treatment. The odds of treatment initiation were ≤30% lower among Asians, non-Hispanic blacks, and Hispanics compared to non-Hispanic whites, after controlling for other variables. For individuals over the age of 60, the odds of initiation were half those of individuals under 44 years old.
Initiation did rise in tandem with severity of depression, however it was still considerably low. Overall just 53% of those who scored ≥10 in the Patient Health Questionnaire-9 initiated treatment.
The authors write that while depression screening in primary care continues to be a step in the right direction, the level of treatment initiation remains ‘suboptimal’. “A better understanding of patient factors, and particularly system-level factors, that influence treatment initiation is needed to inform efforts by heath care systems to improve depression treatment engagement and to reduce disparities.”
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