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Differences in prescribing patterns for anxiety and depression between General Internal Medicine and Family Medicine.

Abstract：

INTRODUCTION:Depression and anxiety are routinely managed by physicians in Family Medicine (FM) or General Internal Medicine (GIM). Because FM requires more behavioral health training than GIM, we sought to determine if prescribing patterns for patients with anxiety, depression, or both differed between FM vs. GIM providers. METHODS:In a cross-sectional design, patient data and provider type were obtained from 2008 to 2013 electronic medical record patient data registry (n=27,225 (FM=10,994, GIM=16,231)) Prescription orders were modeled for specific benzodiazepines and antidepressants and by drug class. Covariates included gender, age, race, marital status and comorbidity index. Separate logistic regression models were computed, before and after adjusting for covariates, to estimate the odds of FM vs. GIM providers prescribing benzodiazepine or antidepressant medication to patients with anxiety, depression, and both disorders. RESULTS:After adjusting for covariates, patients with anxiety alone, depression alone, and both had significantly greater odds of receiving an antidepressant (OR=2.08;95%CI:1.46-2.96, OR=2.13;95%CI:1.48-3.06, and OR=2.26;95%CI:1.09-4.66, respectively) if treated by FM vs. GIM. Benzodiazepine prescription did not differ by physician type. LIMITATIONS:It is not known if results will generalize to other regions of the United States. CONCLUSIONS:Patients with anxiety, depression, and both seen by FM providers, as compared to GIM providers, are more likely to receive antidepressant medications. Further investigation into the determinants of these differences is warranted. Under-treatment in GIM may result in less advantageous outcomes.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Brieler JA,Scherrer JF,Salas J

doi

10.1016/j.jad.2014.09.056

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

153-8

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(14)00620-X

journal_volume

172

pub_type

杂志文章

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