Physicians less likely to prescribe antidepressants to minorities, Medicaid patients

April 05, 2012

ANN ARBOR, Mich.--- African-Americans and Hispanics with major depressive disorder are less likely to get antidepressants than Caucasian patients, and Medicare and Medicaid patients are less likely to get the newest generation of antidepressants.

Researchers from the University of Michigan School of Public Health examined data from 1993 to 2007 to try to understand the antidepressant prescribing patterns of physicians. They looked at two things: who received antidepressants, and what type of antidepressant was prescribed.

They found that race, payment source, physician ownership status and geographical region influenced whether physicians decided to prescribe antidepressants in the first place. Age and payment source influenced which types of antidepressants patients received.

The study found that Caucasians were 1.52 times more likely to be prescribed antidepressants than Hispanic and African-American patients being treated for major depressive disorders. However, patient race was not a factor in the physician's choice of a specific type of antidepressant medication.

"This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviors," said Rajesh Balkrishnan, associate professor in U-M SPH and principal investigator. "This is true in particular for major depressive disorder treatment." Balkrishnan also has an appointment in the College of Pharmacy.

Newer antidepressants, such as SSRI's and SNRI's are considered the first-line pharmaceutical treatments for major depressive disorder. Older generation drugs include TCAs, MAOIs, and others, and tend to have more side-effects.

The study found that Medicare and Medicaid patients were 31 percent and 38 percent less likely to be prescribed antidepressants, respectively, compared to those with private insurance.

Geography and physician ownership status also factored into which patients received antidepressants. Sole practitioners compared to non-owners were 25 percent less likely to prescribe antidepressants, and physicians in metropolitan areas were 27 percent less likely to prescribe antidepressants in all patients with depression.

However, physicians who had seen the patients before were 1.4 times more likely to prescribe antidepressants.

Researchers also analyzed which patients received the newer antidepressants or the older antidepressants. Findings included:This study revealed important implications for mental health policy, Balkrishnan said. "We need policy makers to design interventions to improve physician practice guidelines adherence," he said. "This will help eliminate unnecessary variations among physician practices and to obtain optimal health care for patients."
-end-
Other authors on the manuscript include Hsien-ChangLin, Balkrishnan's former doctoral student, now assistant professor of Health Policy at Indiana University, and Steven Erickson, associate professor at the U-M College of Pharmacy.

The paper, "Physician prescribing patterns of innovative antidepressants in the United States: The care of MDD Patients 1992-2007," the article appeared online last month in the International Journal of Psychiatry in Medicine.

To view the paper: http://www.metapress.com/content/e1658l3v25630qj8/fulltext.html
For more on Balkrishnan: http://www.sph.umich.edu/iscr/faculty/profile.cfm?uniqname=rbalkris
For more on Pharmacy: http://pharmacy.umich.edu/pharmacy/home

The University of Michigan School of Public Health has been promoting health and preventing disease since 1941, and is ranked among the top public health schools in the nation. Whether making new discoveries in the lab or researching and educating in the field, our faculty, students, and alumni are deployed around the globe to promote and protect our health. http://www.sph.umich.edu/

University of Michigan

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.