Category: Federal Forum Posters
Purpose: When remission is not achieved after initial medication trial, sequential antidepressant treatment is usually the next step. While the Veterans Health Administration does publish clinical practice guidelines for the treatment of depression, real-life prescribing practices among veterans are unknown. This project aims to describe next-step pharmacological strategies for treating depressive disorder at the Minneapolis VA Health Care System.
Methods: An electronically generated data report will identify veterans with an initial diagnosis of depressive disorder, identified by ICD-9 and ICD-10 codes. These individuals must have been treated with at least one antidepressant medication in primary care or mental health specialty at the MVAHCS from 2010-2018. We will exclude patients with bipolar disorder, schizophrenia, schizoaffective disorder, psychosis, or dementia. We will use the first three prescription orders issued by VA pharmacy after the index diagnosis date to determine strategies for the first and second step treatments. A pharmacy algorithm, based on dose, strength, and duration of use, was developed to determine five antidepressant prescribing patterns: 1) monotherapy (continue with same dose); 2) optimization (increase dose of same antidepressant); 3) switching to a different antidepressant; 4) combination (add another antidepressant); and 5) augmentation (add a non-antidepressant agent). We will also collect demographic and clinical data (i.e., service utilization).
Results: not applicable
Conclusion: not applicable
Annette Do– Pharmacy Resident, Minneapolis VA Health Care System, St. Paul, MN