Demographic, Clinical, and Functional Factors Associated With Antidepressant Use in the Home Healthcare Elderly

Background: Post-stroke depression is common, yet little is known about factors associated with antidepressant use in this population Methods: Data from the multicenter, prospective Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) registry was used to identify patients with post-stroke depression and to describe factors associated with antidepressant use. The analysis was performed after 3 months in 1751 ischemic stroke patients who had been admitted to 97 hospitals nationwide; 12 month follow-up was available for 1637 patients. The Get with the Guidelines-Stroke database was used to collect baseline data. Patients were classified as depressed based on a self-report scale (the Patient Health Questionnaire-8; score range 0 to 24, score ≥10 indicating depression). Frequencies were compared with Pearson X 2 and unadjusted ORs were calculated. Results: The prevalence of post stroke depression was similar at 3 and 12 months (19% [331/1751] vs 17% [280/1637], respectively, p=0.17). Regardless of depression status, antidepressant use was higher at 12 months (16% [287/1751] vs 20% [334/1637], p=0.002). Antidepressant use was also higher at 12 months in depressed patients (25% [84/331] vs 35% [98/280], p=0.009). The odds of antidepressant use at 3 months was higher in women than men (OR 1.6, 95% CI 1.2-2.1), Whites vs. Blacks (OR 1.7, 95% CI 1.1-2.8), in patients with vs. without cognitive deficits (OR 1.6, 95% CI 1.2-2.1) and in those with more severe disabilities (mRS≥3 vs. mRS<3, OR 1.7, 95% CI 1.3-2.3). Use did not vary with educational level, marital status, living situation, medication insurance coverage, or stroke recurrence. Similar trends were present at 12 months, except with higher use in those with recurrent stroke or TIA (OR 2.1, 95% CI 1.4-3.1). Conclusion: Three-quarters of depressed stroke patients at 3-months and nearly two-thirds at 12 months were not receiving antidepressants. Regardless of depression status, utilization of antidepressants after 3 and 12 months varied based on gender, race/ethnicity, cognitive status, disability level, and after 12-months, stroke recurrence. The reasons for the apparent underuse of antidepressants in patients with prevalent post-stroke depression require further study.

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Factors Associated with Health-Related Quality of Life in Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100005989 ◽

2007 ◽

Vol 34 (2) ◽

pp. 160-166 ◽

Cited By ~ 31

Author(s):

Wilma M. Hopman ◽

Helen Coo ◽

Cathy M. Edgar ◽

Evelyn V. McBride ◽

Andrew G. Day ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Health Related Quality ◽

Baseline Phase ◽

Factors Associated ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

Antidepressant Use

Background:Much research has gone into the assessment of function and health-related quality of life (HRQOL) in those with multiple sclerosis (MS). The Medical Outcomes Study 36-item short form (SF-36) has been widely used in this population but current recommendations are that it be supplemented with condition-specific measures such as the MS Quality of Life Inventory (MSQLI) and the MS Functional Composite (MSFC). The goal of the baseline component of this study was the measurement of generic and condition-specific HRQOL, and the identification of factors associated with these outcomes.Methods:HRQOL was assessed at the baseline phase of a longitudinal study. Participants completed the assessment during their regularly scheduled clinic visit.Results:300 of 387 eligible patients agreed to participate, for a response rate of 77.5%. Age ranged from 22 to 77 years, while duration of MS ranged from 1 to 47 years. Mean SF-36 scores were well below age- and sex-adjusted normative data. Only 240 completed the MSFC component. Higher EDSS, use of support services, pain medications, clinical depression and antidepressant use were associated with poorer HRQOL, while higher income and education were associated with better HRQOL.Conclusions:There is a substantial burden of illness associated with MS when compared to normative HRQOL data. This was more pronounced in physically- than in mentally-oriented domains. Assessment of HRQOL provides a valuable complement to the EDSS by providing information about the patient perception of function and HRQOL beyond that which can be obtained by physical assessment alone.

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Informal Caregiver Decision-Making Factors Associated With Technology Adoption and Use in Home Healthcare

Home Healthcare Now ◽

10.1097/nhh.0000000000000811 ◽

2019 ◽

Vol 37 (6) ◽

pp. 328-336 ◽

Cited By ~ 1

Author(s):

Kyungmi Woo ◽

Aluem Tark ◽

Dawon Baik ◽

Dawn Dowding

Keyword(s):

Decision Making ◽

Technology Adoption ◽

Informal Caregiver ◽

Home Healthcare ◽

Factors Associated ◽

Decision Making Factors

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Demographic and clinical factors associated with different antidepressant treatments: a retrospective cohort study design in a UK psychiatric healthcare setting

BMJ Open ◽

10.1136/bmjopen-2018-022170 ◽

2018 ◽

Vol 8 (9) ◽

pp. e022170 ◽

Cited By ~ 3

Author(s):

Andrea C Fernandes ◽

David Chandran ◽

Mizanur Khondoker ◽

Michael Dewey ◽

Hitesh Shetty ◽

...

Keyword(s):

Cohort Study ◽

Study Design ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Healthcare Setting ◽

Clinical Factors ◽

Factors Associated ◽

Antidepressant Treatments ◽

Cohort Study Design ◽

Antidepressant Use

ObjectiveTo investigate the demographic and clinical factors associated with antidepressant use for depressive disorder in a psychiatric healthcare setting using a retrospective cohort study design.SettingData were extracted from a de-identified data resource sourced from the electronic health records of a London mental health service. Relative risk ratios (RRRs) were obtained from multinomial logistic regression analysis to ascertain the probability of receiving common antidepressant treatments relative to sertraline.ParticipantsPatients were included if they received mental healthcare and a diagnosis of depression with antidepressant treatment between March and August 2015 and exposures were measured over the preceding 12 months.ResultsOlder age was associated with increased use of all antidepressants compared with sertraline, except for negative associations with fluoxetine (RRR 0.98; 95% CI 0.96 to 0.98) and a combination of two selective serotonin reuptake inhibitors (SSRIs) (0.98; 95% CI 0.96 to 0.99), and no significant association with escitalopram. Male gender was associated with increased use of mirtazapine compared with sertraline (2.57; 95% CI 1.85 to 3.57). Previous antidepressant, antipsychotic and mood stabiliser use were associated with newer antidepressant use (ie, selective norepinephrine reuptake inhibitors, mirtazapine or a combination of both), while affective symptoms were associated with reduced use of citalopram (0.58; 95% CI 0.27 to 0.83) and fluoxetine (0.42; 95% CI 0.22 to 0.72) and somatic symptoms were associated with increased use of mirtazapine (1.60; 95% CI 1.00 to 2.75) relative to sertraline. In patients older than 25 years, past benzodiazepine use was associated with a combination of SSRIs (2.97; 95% CI 1.32 to 6.68), mirtazapine (1.94; 95% CI 1.20 to 3.16) and venlafaxine (1.87; 95% CI 1.04 to 3.34), while past suicide attempts were associated with increased use of fluoxetine (2.06; 95% CI 1.10 to 3.87) relative to sertraline.ConclusionThere were several factors associated with different antidepressant receipt in psychiatric healthcare. In patients aged >25, those on fluoxetine were more likely to have past suicide attempt, while past use of antidepressant and non-antidepressant use was also associated with use of new generation antidepressants, potentially reflecting perceived treatment resistance.

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A Preliminary Assessment of the Medical and Functional Factors Associated with Vehicle Crashes by Older Adults

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1998.tb01070.x ◽

1998 ◽

Vol 46 (5) ◽

pp. 556-561 ◽

Cited By ~ 81

Author(s):

Richard V. Sims ◽

Cynthia Owsley ◽

Richard M. Allman ◽

Karlene Ball ◽

Tonya M. Smoot

Keyword(s):

Older Adults ◽

Vehicle Crashes ◽

Preliminary Assessment ◽

Factors Associated ◽

Functional Factors

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Life, mental, and social functional factors associated with a decreased activity in elderly requiring support/care

Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics ◽

10.3143/geriatrics.58.436 ◽

2021 ◽

Vol 58 (3) ◽

pp. 436-445

Author(s):

Kazutaka Horikoshi ◽

Mineko Fujita ◽

Naoko Shimadu ◽

Kengo Takashima

Keyword(s):

Factors Associated ◽

Functional Factors

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Initiation of antidepressant use among refugee and Swedish-born youth after diagnosis of a common mental disorder: findings from the REMAIN study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-020-01951-4 ◽

2020 ◽

Author(s):

Heidi Taipale ◽

Thomas Niederkrotenthaler ◽

Magnus Helgesson ◽

Marit Sijbrandij ◽

Lisa Berg ◽

...

Keyword(s):

Health Care ◽

Mental Disorder ◽

Selective Serotonin Reuptake Inhibitors ◽

Common Mental Disorder ◽

Study Cohort ◽

Clinical Factors ◽

Refugee Youth ◽

Factors Associated ◽

Antidepressant Use ◽

Specialized Health Care

Abstract Purpose The objective of this study was to compare the initiation and type of antidepressant use between refugees and matched Swedish-born youth after a diagnosis of a common mental disorder (CMD) and assess sociodemographic and clinical factors associated with the initiation. Methods The study cohort included youth aged 16–25 years, with an incident diagnosis of CMD based on specialized health care registers in Sweden 2006–2016, without prior antidepressant use during 1 year. One Swedish-born person was matched for each identified refugee youth (N = 3936 in both groups). Initiation of antidepressant use and factors associated with the initiation, were investigated with logistic regression yielding Odds ratios, OR, and 95% Confidence Intervals, CI. Results Refugees were less likely to initiate antidepressant use compared with Swedish-born (40.5% vs. 59.6%, adjusted OR 0.43, 95% CI 0.39–0.48). Selective serotonin reuptake inhibitors (SSRIs) were less frequently initiated for refugees than Swedish-born (71.2% vs. 81.3% of initiations, p < 0.0001). Sertraline was the most commonly initiated antidepressant both for refugees (34.3%) and Swedish-born individuals (40.3%). Among refugees, factors associated with increased odds of antidepressant initiation were previous use of anxiolytics or hypnotics, previous sickness absence of < 90 days, cancer and older age (OR range 1.07–2.72), and less than 5 years duration of residency in Sweden was associated with decreased odds (OR 0.76, 95% CI 0.63–0.92). Conclusion Young refugees with a CMD seem to initiate antidepressants in general and those most effective considerably less often than their Swedish-born counterparts.

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