Abstract | OBJECTIVES: DESIGN: Retrospective cohort study. SETTING: Medicare 5% sample data (2011-2013). PARTICIPANTS: Older adults (aged 65 years or older) with dementia and MDD. MEASUREMENTS: The first antidepressant prescription claim from 1 May 2011 through 30 April 2012 was considered the index prescription start date (IPSD). Adherence during acute- and continuation-phase AMM was based on HEDIS guidelines. Study outcomes included all-cause mortality, all-cause hospitalization, and falls/factures (with mortality being the competing event for hospitalization and falls/fractures) during follow-up from end of acute-/continuation-phase AMM adherence. Due to the proportionality assumption violation of Cox models, fully non-parametric approaches (Kaplan-Meier and modified Gray's test) were used for time-to-event analysis adjusting for the inverse probability of treatment weights. RESULTS: Final study samples consisted of 4330 (adherent (N) = 3114 (71.92%)) and 3941 (adherent (N) = 2407 (61.08%)) older adults with dementia and MDD during acute- and continuation-phase treatments, respectively. No significant difference (p > 0.05) between adherent and non-adherent groups was observed for all-cause mortality and falls/fractures in both the acute and continuation phases. There was a significant difference in time to all-cause hospitalization during acute-phase treatment (p = 0.018), with median times of 530 (95% CI: 499-587) and 425 (95% CI: 364-492) days for adherent and non-adherent groups, respectively. CONCLUSIONS: Acute-phase adherence to HEDIS AMM was associated with reductions in all-cause hospitalization risk among older adults with dementia and MDD.
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Authors | Sandipan Bhattacharjee, Suniya Naeem, Shannon M Knapp, Jeannie K Lee, Asad E Patanwala, Nina Vadiei, Daniel C Malone, Wei-Hsuan Lo-Ciganic, William J Burke |
Journal | Journal of clinical medicine
(J Clin Med)
Vol. 9
Issue 10
(Oct 20 2020)
ISSN: 2077-0383 [Print] Switzerland |
PMID | 33092169
(Publication Type: Journal Article)
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