Work

B3-2: Validation of Administrative and Claims Data for the Identification of Anaphylaxis Cases in the Mini-Sentinel Distributed Database

Year: 2013

Type: article

Abstract: descriptors, PHQ-9 data, ICD-9CM depression codes, and antidepressant drugs.Analytical tests included Cochran-Armitage test for trend, Cochran-Mantel-Haenszel test and logistic regression modeling for year of maximum PHQ-9 score.PHQ-9 tests were considered independent only if they were: initial events; 10+ months after the most recent test; or immediately following a prior test with a total score of less than 5 (normal).The logistic regression model included any depression diagnosis (DEP), year, sex, age, maximum PHQ-9 score-5 categories from Normal to Severe Depression, any PCP measured PHQ-9, and any behavioral health measured PHQ-9.Results: Study population included 294 PCP (~181 annually) and 216,494 patients (~105,240 annually).The measurement of independent PHQ-9 in patients managed by primary care providers increased from 0.7% (2005) to 13.5% (2011); Z = 153.34,P <0.001.Patients with an independent PHQ-9 test were 17.87 (95% CI: 17.43-18.31)times more likely to have a diagnosis of depression.After adjustment in the logistic model, patients with DEP were more likely to be prescribed an antidepressant drug, rate ratio = 3.56 (3.33-3.80).As PHQ-9 scores increased, associated rate ratios (compared to normal PHQ-9) increased incrementally, 1.26 (1.82-1.35),2.07 (1.90-2.25),3.05 (2.79-3.34),and 4.18 (3.72-4.70),for PHQ-9 scores 5-9, 10-14, 15-19 and 20+, respectively.Conclusions: Our study found PHQ-9 use in primary care clinical practice increased significantly over 7 years.Patients having PHQ-9 testing in primary care were more likely to have a diagnosis of depression.Patients with increased severity of PHQ-9 scores were substantially more likely to be prescribed an antidepressant drug.PHQ-9 data appear to increase the diagnosis of clinical depression and prescribing of antidepressant drugs in primary care.

Source: Clinical Medicine & Research

DOI: 10.3121/cmr.2013.1176.b3-2