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Richardson LP, DiGiuseppe D, Christakis DA, McCauley E, Katon W. Quality of Care for Medicaid-Covered Youth Treated With AntidepressantTherapy. Arch Gen Psychiatry. 2004;61(5):475–480. doi:10.1001/archpsyc.61.5.475
Although antidepressant use has increased in pediatric populations,
few studies have addressed the quality of follow-up care or duration of treatment
for depressed youth.
To evaluate the quality of care for antidepressant-treated youth, using
the Health Plan Employer Data and Information Set guidelines (≥3 visits
in the 3 months after a new antidepressant prescription fill and continuation
of antidepressant use at 3 and 6 months) as a benchmark.
Administrative records were examined for 1205 Medicaid-covered youth
(aged 5-18 years) who presented with a "new episode" of depression in 1998.
Statistics were generated to describe the number of follow-up visits and duration
of treatment within 6 months of first prescription fill.
A total of 507 (42.1%) youth with new episodes of depression were treated
with antidepressants. Selective serotonin reuptake inhibitors accounted for
80.9% of prescriptions. Twenty-eight percent (28.1%) of youth with an antidepressant
fill had 3 or more follow-up visits in the subsequent 3 months; however, an
additional 29.2% had no further provider visits. Selective serotonin reuptake
inhibitors were continued by 46.6% of treated youth at 3 months and by 26.3%
at 6 months.
Many antidepressant-treated youth do not receive adequate follow-up
or duration of treatment. Future studies should address reasons for poor follow-up
and methods to improve monitoring for these youth.
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