scholarly journals Patterns and Predictors of Depression Treatment among Older Adults with Parkinson’s Disease and Depression in Ambulatory Care Settings in the United States

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Sandipan Bhattacharjee ◽  
Nina Vadiei ◽  
Lisa Goldstone ◽  
Ziyad Alrabiah ◽  
Scott J. Sherman
Keyword(s):  
United States ◽  
Older Adults ◽  
Medical Care ◽  
Odds Ratio ◽  
The United States ◽  
Depression Treatment ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
To Receive ◽  
Predictors Of Depression

Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD) in the United States (US). The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005–2011) from the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department of the National Hospital Ambulatory Medical Care Survey (NHAMCS). The final study sample consisted of visits by older adults with dPD. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariate logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Individuals with dPD and polypharmacy were 74% more likely to receive depression treatment (odds ratio = 1.743, 95% CI 1.376–2.209), while dPD subjects with comorbid chronic conditions were 44% less likely (odds ratio = 0.559, 95% CI 0.396–0.790) to receive depression treatment. Approximately six out of ten older adults with PD and depression received depression treatment. Treatment options for dPD are underutilized in routine clinical practice, and further research should explore how overall medical complexity presents a barrier to depression treatment.

scholarly journals Depression Treatment among Adults with Multiple Sclerosis and Depression in Ambulatory Care Settings in the United States

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Sandipan Bhattacharjee ◽  
Lisa Goldstone ◽  
Queeny Ip ◽  
Terri Warholak
Keyword(s):  
United States ◽  
Medical Care ◽  
National Level ◽  
The United States ◽  
Cross Sectional Study ◽  
Depression Treatment ◽  
Cross Sectional ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
Predictors Of Depression

Background. There is little information regarding depression treatment patterns among adults with MS and depression in ambulatory settings at national level in the United States (US).Objectives. The objectives of this study were to identify patterns and predictors of depression treatment in ambulatory settings in US among adults with MS and depression.Methods. A cross-sectional study was conducted by pooling multiple years (2005–2011) of National Ambulatory Medical Care Survey and the outpatient department of the National Hospital Ambulatory Medical Care Survey data. The final study sample was comprised of ambulatory visits among adults with MS and depression. Dependent variable of this study was pharmacological treatment for depression with or without psychotherapy. Predictors of depression treatment were determined by conducting multivariable logistic regression.Results. Out of all ambulatory visits involving MS diagnosis, 20.59% also involved a depression diagnosis. Depression treatment was observed in 57.25% of the study population. Fluoxetine was the most prescribed individual antidepressant. Age and total number of chronic diseases were significant predictors of depression treatment.Conclusion. Approximately six out of ten ambulatory visits involving MS and depression recorded some form of depression treatment. Future longitudinal studies should examine health outcomes associated with depression treatment in this population.

Inappropriate prescriptions for the aging population of the United States: an analysis of the National Ambulatory Medical Care Survey, 1997

2002 ◽  
Vol 11 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Boji Huang ◽  
Kenneth A. Bachmann ◽  
Xuming He ◽  
Randi Chen ◽  
Jennifer S. McAllister ◽  
...  
Keyword(s):  
United States ◽  
Medical Care ◽  
Aging Population ◽  
The United States ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
Inappropriate Prescriptions

scholarly journals 1099. Antibiotic Prescriptions for Acute Gastroenteritis during Office and Emergency Department Visits–United States, 2006–2015

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S330-S330
Author(s):  
Jennifer P Collins ◽  
Louise Francois Watkins ◽  
Laura M King ◽  
Monina Bartoces ◽  
Katherine Fleming-Dutra ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Medical Care ◽  
Acute Gastroenteritis ◽  
Antibiotic Use ◽  
The United States ◽  
Emergency Department Visits ◽  
Antibiotic Prescribing ◽  
Care Survey ◽  
Ambulatory Medical Care

Abstract Background Acute gastroenteritis (AGE) is a major cause of office and emergency department (ED) visits in the United States. Most patients can be managed with supportive care alone, although some require antibiotics. Limiting unnecessary antibiotic use can minimize side effects and the development of resistance. We used national data to assess antibiotic prescribing for AGE to target areas for stewardship efforts. Methods We used the 2006–2015 National Hospital Ambulatory Medical Care Survey of EDs and National Ambulatory Medical Care Survey to describe antibiotic prescribing for AGE. An AGE visit was defined as one with a new problem (<3 months) as the main visit indication and an ICD-9 code for bacterial or viral gastrointestinal infection or AGE symptoms (nausea, vomiting, and/or diarrhea). We excluded visits with ICD-9 codes for Clostridium difficile or an infection usually requiring antibiotics (e.g., pneumonia). We calculated national annual percentage estimates based on weights of sampled visits and used an α level of 0.01, recommended for these data. Results Of the 12,191 sampled AGE visits, 13% (99% CI: 11–15%) resulted in antibiotic prescriptions, equating to an estimated 1.3 million AGE visits with antibiotic prescriptions annually. Antibiotics were more likely to be prescribed in office AGE visits (16%, 99% CI: 12–20%) compared with ED AGE visits (11%, 99% CI: 9–12%; P < 0.01). Among AGE visits with antibiotic prescriptions, the most frequently prescribed were fluoroquinolones (29%, 99% CI: 21–36%), metronidazole (18%, 99% CI: 13–24%), and penicillins (18%, 99% CI: 11–24%). Antibiotics were prescribed for 25% (99% CI: 8–42%) of visits for bacterial AGE, 16% (99% CI: 12–21%) for diarrhea without nausea or vomiting, and 11% (99% CI: 8–15%) for nausea, vomiting, or both without diarrhea. Among AGE visits with fever (T ≥ 100.9oF) at the visit, 21% (99% CI: 11–31%) resulted in antibiotic prescriptions. Conclusion Patients treated for AGE in office settings were significantly more likely to receive prescriptions for antibiotics compared with those seen in an ED, despite likely lower acuity. Antibiotic prescribing was also high for visits for nausea or vomiting, conditions that usually do not require antibiotics. Antimicrobial stewardship for AGE is needed, especially in office settings. Disclosures All authors: No reported disclosures.

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