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The influence of comorbid chronic medical conditions on the adequacy of depression care for older Americans.
J Am Geriatr Soc. 2005 Dec; 53(12):2178-83.JA

Abstract

OBJECTIVES

To assess the effect of the co-occurrence of four common chronic medical conditions (hypertension, diabetes mellitus, arthritis, heart disease) on the probability of receiving adequate depression treatment.

DESIGN

Retrospective analysis of the 2000 and 2001 Medical Expenditure Panel Surveys (MEPS).

SETTING

Households in the United States.

PARTICIPANTS

MEPS respondents aged 65 and older with self-reported depression (N=498).

MEASUREMENTS

Adequate depression treatment is defined as receiving eight psychotherapy sessions or filling at least four antidepressant prescriptions at a minimally adequate dosage. Comorbid diabetes mellitus, hypertension, heart disease, and arthritis in older persons with depression were identified from patient self-report.

RESULTS

An estimated 34% (95% confidence interval=28-39%) of older persons with self-reported depression received an adequate course of depression treatment during a calendar year. Having hypertension or diabetes mellitus was associated with significantly greater odds of receiving adequate depression care (hypertension odds ratio (OR)=1.81, P=.02; diabetes mellitus OR=1.77, P=.03). Having heart disease or arthritis was not significantly associated with the odds of receiving adequate depression care.

CONCLUSION

Some chronic medical conditions are associated with a greater likelihood of receiving adequate depression care; comorbid medical conditions do not result in lower quality of depression treatment in older persons. The high prevalence rates of comorbid depression and low rates of adequate depression care in elderly persons with chronic illnesses point to the importance of improving primary care depression treatment or enhancing specialty mental health referral.

Authors+Show Affiliations

Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32611, USA. jharman@ufl.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16398906

Citation

Harman, Jeffrey S., et al. "The Influence of Comorbid Chronic Medical Conditions On the Adequacy of Depression Care for Older Americans." Journal of the American Geriatrics Society, vol. 53, no. 12, 2005, pp. 2178-83.
Harman JS, Edlund MJ, Fortney JC, et al. The influence of comorbid chronic medical conditions on the adequacy of depression care for older Americans. J Am Geriatr Soc. 2005;53(12):2178-83.
Harman, J. S., Edlund, M. J., Fortney, J. C., & Kallas, H. (2005). The influence of comorbid chronic medical conditions on the adequacy of depression care for older Americans. Journal of the American Geriatrics Society, 53(12), 2178-83.
Harman JS, et al. The Influence of Comorbid Chronic Medical Conditions On the Adequacy of Depression Care for Older Americans. J Am Geriatr Soc. 2005;53(12):2178-83. PubMed PMID: 16398906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of comorbid chronic medical conditions on the adequacy of depression care for older Americans. AU - Harman,Jeffrey S, AU - Edlund,Mark J, AU - Fortney,John C, AU - Kallas,Henrique, PY - 2006/1/10/pubmed PY - 2006/2/9/medline PY - 2006/1/10/entrez SP - 2178 EP - 83 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 53 IS - 12 N2 - OBJECTIVES: To assess the effect of the co-occurrence of four common chronic medical conditions (hypertension, diabetes mellitus, arthritis, heart disease) on the probability of receiving adequate depression treatment. DESIGN: Retrospective analysis of the 2000 and 2001 Medical Expenditure Panel Surveys (MEPS). SETTING: Households in the United States. PARTICIPANTS: MEPS respondents aged 65 and older with self-reported depression (N=498). MEASUREMENTS: Adequate depression treatment is defined as receiving eight psychotherapy sessions or filling at least four antidepressant prescriptions at a minimally adequate dosage. Comorbid diabetes mellitus, hypertension, heart disease, and arthritis in older persons with depression were identified from patient self-report. RESULTS: An estimated 34% (95% confidence interval=28-39%) of older persons with self-reported depression received an adequate course of depression treatment during a calendar year. Having hypertension or diabetes mellitus was associated with significantly greater odds of receiving adequate depression care (hypertension odds ratio (OR)=1.81, P=.02; diabetes mellitus OR=1.77, P=.03). Having heart disease or arthritis was not significantly associated with the odds of receiving adequate depression care. CONCLUSION: Some chronic medical conditions are associated with a greater likelihood of receiving adequate depression care; comorbid medical conditions do not result in lower quality of depression treatment in older persons. The high prevalence rates of comorbid depression and low rates of adequate depression care in elderly persons with chronic illnesses point to the importance of improving primary care depression treatment or enhancing specialty mental health referral. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16398906/The_influence_of_comorbid_chronic_medical_conditions_on_the_adequacy_of_depression_care_for_older_Americans_ L2 - https://doi.org/10.1111/j.1532-5415.2005.00511.x DB - PRIME DP - Unbound Medicine ER -