Antidepressant Medication Use for Primary Care Patients with and without Medical Comorbidities: A National Electronic Health Record (EHR) Network Study

Article Figures & Data

Table 1.

Provider Characteristics (n = 209)

Table 2.

Minimum and Full Doses of Antidepressant Medication and Proportion of Patients on each Medication (n = 1163)

Medication Category	Total Patients on Medication (n [%])	Minimum Dose (mg)	Full Dose (mg)
Selective serotonin reuptake inhibitors
Citalopram	290 (24.9)	20	40
Escitalopram	261 (22.4)	10	20
Fluoxetine	226 (19.7)	20	40
Paroxetine	66 (5.7)	20	40
Sertraline	156 (13.4)	50	100
Serotonin-norepinephrine reuptake inhibitors
Duloxetine	72 (6.2)	30	60
Venlafaxine	78 (6.7)	75	150
Other
Bupropion	209 (18.0)	150	300
Mirtazapine	23 (2.0)	15	30
Nefazodone	1 (0.1)	300	600

Table 3.

Characteristics of the Study Population (n = 1513)

Comorbid Condition	Total with Comorbidity	Age Distribution (Years)			Gender Distribution
Comorbid Condition	Total with Comorbidity	<40 (n = 566)	40–59 (n = 601)	≥60 (n = 346)	Women (n = 967)	Men (n = 546)
Coronary heart disease	79 (5.2)	1 (1.3)	17 (21.5)	61 (77.2)	41 (51.9)	38 (48.1)
Cerebrovascular disease	46 (3.0)	0 (0.0)	6 (13.0)	40 (87.0)	29 (63.0)	17 (37.0)
Diabetes	172 (11.4)	17 (9.9)	66 (38.4)	89 (51.7)	101 (58.7)	71 (41.3)
Cancer	55 (3.6)	1 (1.8)	15 (27.3)	39 (70.9)	34 (61.8)	21 (38.2)
Congestive heart failure	21 (1.4)	0 (0.0)	2 (9.5)	19 (90.5)	13 (61.9)	8 (38.1)
Chronic obstructive pulmonary disease	51 (3.4)	0 (0.0)	14 (27.5)	37 (72.5)	30 (58.8)	21 (41.2)
Comorbidities
0	1,200 (79.3)	548 (45.7)	498 (41.5)	154 (12.8)	783 (65.3)	417 (34.8)
1	224 (14.8)	17 (75.9)	88 (39.3)	119 (53.1)	133 (59.4)	91 (40.6)
≥2	89 (5.9)	1 (1.1)	15 (16.9)	73 (82.0)	51 (57.3)	38 (42.7)

Table 4.

Proportion of Patients Prescribed Any Antidepressant Medication by Comorbidity (n = 1513)

Comorbidity	Patients Who Were Prescribed an Antidepressant (%)		Likelihood of Being Prescribed Antidepressant
Comorbidity	Patients with Comorbidity	Patients without Comorbidity	Odds Ratio^*	95% CI
Coronary heart disease	67.1	77.4	0.72	0.43–1.20
Cerebrovascular disease	65.2	77.2	0.70	0.37–1.33
Diabetes	73.8	77.3	0.96	0.66–1.40
Cancer	63.6	77.4	0.61	0.34–1.10
Congestive heart failure	71.4	76.9	0.96	0.37–2.54
Chronic obstructive pulmonary disease	72.6	77.0	0.97	0.51–1.84
Any comorbidity	72.2	78.1	0.87	0.63–1.21

* Odds ratios for patients who have a comorbidity compared to patients who do not have a comorbidity, adjusted for age and sex.

Table 5.

Proportion on Minimum or Full dose Antidepressant Medication by Comorbidity (n = 1163)

Comorbidity	Minimum Dose of Antidepressant Medication				Full Dose of Antidepressant Medication
	Patients Prescribed (%)		Likelihood of Prescription		Patients Prescribed (%)		Likelihood of Prescription
	Patients Who Have Comorbidity	Patients Who Do No Have Comorbidity	Odds Ratio^*	95% CI	Patients Who Have Comorbidity	Patients Who Do No Have Comorbidity	Odds Ratio^*	95% CI
Coronary heart disease	84.9	91.6	0.83	0.36–1.88	32.1	37.9	1.07	0.58–1.98
Cerebrovascular disease	80.0	91.6	0.74	0.28–1.94	10.0	38.4	0.26	0.08–0.88
Diabetes	85.0	92.1	0.69	0.39–1.21	33.1	38.2	1.00	0.67–1.51
Cancer	82.9	91.6	0.72	0.28–1.82	31.4	37.9	1.04	0.50–2.19
Congestive heart failure	66.7	91.6	0.32	0.10–1.01	26.7	37.8	0.90	0.28–2.92
Chronic obstructive pulmonary disease	83.8	91.6	0.81	0.32–2.07	27.0	38.0	0.84	0.39–1.78
Any comorbidity	85.0	92.9	0.68	0.40–1.14	30.1	39.5	0.88	0.61–1.25