Impact of antidepressant dispensing on health service use among veterans with stroke.

Jia H, Ried LD, Feng H, Cameon R, Wang X. Impact of antidepressant dispensing on health service use among veterans with stroke. Journal of the American Pharmacists Association : JAPhA. 2011 Jan 1; 51(1):65-71.

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Abstract:

OBJECTIVE: To examine the association between dispensing of a selective serotonin reuptake inhibitor (SSRI) antidepressant medication and inpatient and outpatient service use in a cohort of veterans with confirmed acute stroke. DESIGN: Retrospective study.Setting: Southeastern U. S. Veterans Health Administration (VHA) network, from October 1, 2000, to September 30, 2001. PATIENTS: 785 veterans with confirmed acute stroke.Intervention: VHA and Medicare databases were used to obtain outcome information during the 12 months after the index stroke date. MAIN OUTCOME MEASURES: Number of inpatient admissions, length of inpatient stays, and number of outpatient clinic stops for all causes. RESULTS: Among the study cohort (n = 785), 12% had an SSRI dispensed 30 days or less poststroke, 19% had an SSRI dispensed between 31 and 365 days poststroke, and 69% were not dispensed an SSRI poststroke. After adjusting for risk factors, no significant association was found between time to first SSRI dispensing and inpatient use. However, patients with an early SSRI dispensing were more likely to have a greater number of all-cause outpatient stops compared with patients with later or no SSRI dispensing. Regardless of time to first dispensing, patients dispensed an SSRI had more outpatient clinic stops than patients without the medication. CONCLUSION: SSRI dispensing was not predictive of inpatient use but was a strong predictor of all-cause outpatient clinic stops.