Who diagnosed and prescribed what? Using provider details to inform observational research.
Who diagnosed and prescribed what? Using provider details to inform observational research.
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DOI：
10.1002/pds.4685
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发表时间：
2018-12
影响因子：
2.6
通讯作者：
Miller M
中科院分区：
文献类型：
--
作者：
Bushnell GA;Stürmer T;Mack C;Pate V;Miller M
描述服用抗抑郁药物的抑郁症患者从同一提供者那里获得抑郁症诊断和处方的频率，以及当同时使用苯二氮卓类药物时，这两种处方来自同一提供者的频率。使用美国医疗保健索赔数据，我们创建了一组成年人(18-)，他们被诊断为抑郁症，并开始服用抗抑郁药物。我们通过提供商专业和提供商标识符来检验a)第一个抗抑郁药处方填充和最近端抑郁诊断之间的一致性，以及b)同时使用苯二氮类药物和抗抑郁药启动剂的初始抗抑郁药和苯二氮卓类处方填充之间的一致性。在245,166名最近被诊断为抑郁症的抗抑郁药启动者中(女性=67%；中位年龄=39岁)，指定抑郁症诊断的提供者的专业与已知提供者详细信息的抗抑郁药处方者的专业匹配的案例中(提供者标识符合率=93%)。由全科医生(98%)或精神病学家(92%)诊断的成年人的符合率高于由心理学家(74%)诊断的成年人。在同时使用抗抑郁药和苯二氮卓类药物的新使用者(n=19371)中，这两种处方分别有94%和93%的时间是由相同的提供者专科和提供者识别符出具的。绝大多数接受抗抑郁药物处方和抑郁诊断的患者似乎都是从同一家供应商获得诊断和抗抑郁药物的，这表明，当在患者被诊断为抑郁症的前后发放抗抑郁药时，抗抑郁药很可能是针对抑郁症开的。此外，绝大多数同时使用苯二氮卓类药物的患者似乎是在一家供应商的指导下这样做的。
To describe how often patients with depression initiating antidepressants receive their depression diagnosis and prescriptions from the same provider and, when simultaneously initiating benzodiazepines, how often both prescriptions come from the same provider. Using US healthcare claims data, we created a cohort of adults (18-64 years) with a depression diagnosis who initiated antidepressants. We examined concordance by provider specialty and provider identifier between a) the first antidepressant prescription fill and most proximal depression diagnosis, and b) the initial antidepressant and benzodiazepine prescription fills among simultaneous benzodiazepine and antidepressant initiators. Among 245,166 antidepressant initiators with a recent depression diagnosis (female=67%; median age=39), the specialty of the provider assigning the depression diagnosis matched the antidepressant prescriber’s specialty in 94% of cases with known provider details (provider identifier concordance=93%). Concordance was higher for adults diagnosed by a general practitioner (98%) or psychiatrist (92%) than for those diagnosed by a psychologist (74%). In simultaneous new users of antidepressants and benzodiazepines (n=19,371), both prescriptions were issued by the same provider specialty and provider identifier 94% and 93% of the time, respectively. The vast majority of patients who received antidepressant prescriptions and depression diagnoses appear to have received both diagnosis and antidepressants from the same provider, suggesting that when antidepressants are issued around the time a patient is diagnosed with depression, the antidepressant was likely prescribed for depression. In addition, the great majority of patients who simultaneously initiate benzodiazepines appear to do so under the direction of one provider.
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影响因子：
3
作者：
Schneeweiss, Sebastian;Patrick, Amanda R.;Glynn, Robert J.
通讯作者：
Glynn, Robert J.
影响因子：
5.4
作者：
Brookhart, MA;Wang, PS;Schneeweiss, S
通讯作者：
Schneeweiss, S
影响因子：
5.7
作者：
Ong, Mei-Sing;Olson, Karen L.;Mandl, Kenneth D.
通讯作者：
Mandl, Kenneth D.
影响因子：
25.8
作者：
Bushnell, Greta A.;Sturmer, Til;Miller, Matthew
通讯作者：
Miller, Matthew
影响因子：
7.2
作者：
Rassen, Jeremy A.;Brookhart, M. Alan;Glynn, Robert J.;Mittleman, Murray A.;Schneeweiss, Sebastian
通讯作者：
Schneeweiss, Sebastian