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Patients with depression plus substance use disorder less likely to receive treatment

14 Nov 2020

Patients with co-occurring depression and substance use disorders don’t usually receive guideline-concordant depression therapy despite available treatments for depression, a study has found.

“Clinical practice guidelines recommend concurrent treatment of co-occurring depression and substance use disorders, [but] the degree to which patients with substance use disorders receive guideline-concordant treatment for depression is unknown,” the investigators said.

To address this, they conducted a retrospective cohort study of 53,034 patients diagnosed with a depressive disorder in fiscal year 2017 in the US Veterans Health Administration. The association of comorbid substance use disorders with guideline-concordant depression treatment, including both medication and psychotherapy, was assessed while adjusting for patient demographic and clinical characteristics.

Across metrics, guideline-concordant depression therapy was lower for patients with co-occurring depression and substance use disorders than those without substance use disorders.

Covariate-adjusted models of antidepressant treatment showed similar findings, such that patients with substance use disorders had 21-percent lower likelihood of guideline-concordant acute treatment (adjusted odds ratio [aOR], 0.79, 95 percent confidence interval [CI], 0.73–0.84) and 26-percent lower probability of continuing treatment (aOR, 0.74, 95 percent CI, 0.69–0.79).

Concerning psychotherapy, patients with co-occurring depression and substance use disorders had 13-percent lower chances of adequate acute-phase treatment (aOR, 0.87, 95 percent CI, 0.82–0.91) and 19-percent lower likelihood of psychotherapy continuation (aOR, 0.81, 95 percent CI, 0.73–0.89).

“Efforts to improve the provision of care to those with co-occurring substance use disorders should focus on clinician-based interventions and use of integrated care models to improve the quality of depression treatment,” the investigators said.

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Most Read Articles
07 Aug 2020
Concomitant treatment with a nonsteroidal anti-inflammatory drug (NSAID) following myocardial infarction (MI) is associated with a higher risk of cardiovascular and bleeding events, a study has shown.
Roshini Claire Anthony, 06 Oct 2020

Several strategies have been proposed to help manage the adverse events (AEs) that emerged during the BEACON CRC trial which assessed the effect of encorafenib plus cetuximab in patients with BRAF V600E mutant metastatic colorectal cancer (mCRC) who had progressed after one or two prior regimens.