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Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2012

Open Access 01-12-2012 | Primary research

Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care

Authors: Antoni Sicras-Mainar, Jorge Maurino, Luis Cordero, Milagrosa Blanca-Tamayo, Ruth Navarro-Artieda

Published in: Annals of General Psychiatry | Issue 1/2012

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Abstract

Background

The aim of the study was to determine the most common treatment strategies and their costs for patients with an inadequate response to first-line antidepressant treatment (AD) in primary care.

Method

A retrospective cohort study of medical records from six primary care centers was conducted. Adults with a major depressive disorder diagnosis, at least 8 weeks of AD treatment after the first prescription, and patient monitoring for 12 months were analyzed. Healthcare (direct cost) and non-healthcare costs (indirect costs; work productivity losses) were described.

Results

A total of 2,260 patients were studied. Forty-three percent of patients (N = 965) presented an inadequate response to treatment. Summarizing the different treatment approaches: 43.2% were switched to another AD, 15.5% were given an additional AD, AD dose was increased in 14.6%, and 26.7% remained with the same antidepressant agent. Healthcare/annual costs were 451.2 Euros for patients in remission vs. 826.1 Euros in those with inadequate response, and productivity losses were 991.4 versus 1,842.0 Euros, respectively (p < 0.001).

Conclusion

Antidepressant switch was the most common therapeutic approach performed by general practitioners in naturalistic practice. A delay in treatment change when no remission occurs and a significant heterogeneity in management of these patients were also found.
Appendix
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Metadata
Title
Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care
Authors
Antoni Sicras-Mainar
Jorge Maurino
Luis Cordero
Milagrosa Blanca-Tamayo
Ruth Navarro-Artieda
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2012
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/1744-859X-11-22

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