Treatment Initiation for Depression Suboptimal in Primary Care

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Treatment initiation for depression is suboptimal, even though treatment is widely available.
Treatment initiation for depression is suboptimal, even though treatment is widely available.

HealthDay News — Treatment initiation for depression remains suboptimal in the primary care setting, despite wide availability of effective treatments and increased detection efforts, according to a study published in the Journal of General Internal Medicine.

Beth Waitzfelder, PhD, from the Kaiser Permanente Center for Health Research in Honolulu, and colleagues assessed medical records from 241,251 adults with newly diagnosed depression in primary care settings among 5 health care systems (from 2010 to 2013).

The researchers found that 35.7% of patients with newly diagnosed depression initiated treatment. Controlling for all other variables, the odds of Asians, non-Hispanic blacks, and Hispanics initiating treatment were 30% lower compared to non-Hispanic whites. Additionally, the odds of patients ≥60 years of age starting treatment were half those of patients <44 years of age. Treatment initiation for depression increased with the severity of the condition, but initiation was still only 53% among patients with a Patient Health Questionnaire-9 depression score ≥10.

"Better understanding of patient factors, and particularly system-level factors, that influence treatment initiation is needed to inform the efforts of heath care systems to improve depression treatment engagement and reduce disparities," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.


Waitzfelder B, Stewart C, Coleman KJ, et al. Treatment initiation for new episodes of depression in primary care settings [published online February 8, 2018]. J Gen Intern Med. doi:10.1007/s11606-017-4297-2

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