Impact of antidepressant drug adherence on comorbid medication use and resource utilization.

Abstract

BACKGROUND:

Patients with depression are often nonadherent to therapy for depression and chronic comorbid conditions.

METHODS:

To determine whether improved antidepressant medication adherence is associated with an increased likelihood of chronic comorbid disease medication adherence and reduced medical costs, we conducted a retrospective study of patients initiating antidepressant drug therapy with evidence of dyslipidemia, coronary artery disease (CAD), or both; diabetes mellitus (DM); or CAD/dyslipidemia and DM identified from a claims database. Measures included antidepressant medication adherence, measured by medication possession ratio during 180 days without a 15-day gap before 90 days of therapy; comorbid medication adherence, measured by medication possession ratio during 1 year; and the association between improved antidepressant drug adherence and disease-specific and total medical costs.

RESULTS:

Of 8040 patients meeting the study criteria, those adherent to antidepressant medication were more likely to be adherent to comorbid therapy vs those nonadherent to antidepressant drug therapy (CAD/dyslipidemia: odds ratio [OR], 2.13; DM: OR, 1.82; and CAD/dyslipidemia/DM: OR, 1.45; P<.001 for all). Patients adherent to antidepressant drug therapy also had significantly lower disease-specific charges vs nonadherent patients (17% lower in CAD/dyslipidemia, P = .02; 8% lower in DM, P = .39; and 14% lower in CAD/dyslipidemia/DM, P = .38). These patients also incurred lower total medical charges (6.4% lower in CAD/dyslipidemia, P = .048; 11.8% lower in DM, P = .04; and 19.8% lower in CAD/dyslipidemia/DM, P = .03).

CONCLUSIONS:

Antidepressant drug adherence was associated with increased comorbid disease medication adherence and reduced total medical costs for CAD/dyslipidemia, DM, and CAD/dyslipidemia/DM. Future studies should investigate the relationship between increased adherence and costs beyond 1 year.

• Authors: Wayne Katon, Christopher Ron Cantrell, Michael C Sokol, Evelyn Chiao, Joette M Gdovin
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 165 Issue 21 Pg. 2497-503 (Nov 28 2005) ISSN: 0003-9926 [Print] United States
• PMID: 16314547 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents

Topics

• Antidepressive Agents (economics, therapeutic use)
• Coronary Disease (complications, economics)
• Depression (complications, drug therapy)
• Diabetes Mellitus (economics)
• Drug Utilization Review
• Dyslipidemias (complications, economics)
• Female
• Health Care Costs
• Humans
• Male
• Middle Aged
• Patient Compliance
• Retrospective Studies
• United States