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KMID : 1011320130060020093
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Journal of Pharmacoepidemiology and Risk Management
2013 Volume.6 No. 2 p.93 ~ p.103
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A Retrospective Analysis for Persistence of Selective Serotonin Reuptake Inhibitors Among the Elderly Depressive Patients
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Kim Ye-Jee
Lee Joong-Yub
Choi Nam-Kyong
Jung Sun-Young
Seong Jong-Mi
Shin Ju-Young
Park Byung-Joo
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Abstract
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Objective: The aim of this study was to estimate the persistence of selective serotonin reuptake inhibitor (SSRI) use and to identify factors associated with 30-day persistence of SSRI use for the elderly depressive patients.
Methods: Health insurance claims records were obtained from the Korea Health Insurance Review and Assessment Service database between January 1, 2005 and June 30, 2006. We identified elderly patients aged 65 to 99 years with depression, who were initiated with SSRIs between July 1 and December 31, 2005. The SSRIs included citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. Persistence was evaluated using the duration of SSRI use which was determined as the number of days from prescription initiation to discontinuation. Time interval between each prescription less than a half of previous prescription duration was considered persistent use. Time to discontinuation of SSRI was analyzed using Kaplan-Meier method. Factors associated with 30-days persistence of SSRI were compared by chi-squared tests, and logistic regression was utilized.
Results: This study included 7,464 elderly patients for analysis. The proportions of patients remained on SSRI treatment for 30 and 180 days after index date were 49.2%, 20.3%, respectively. Hypertension (adjusted odds ratio 1.21, 95% confidence interval 1.09-1.34), ischemic stroke (1.24, 1.11-1.39), arthritis (1.15, 1.05-1.28) and osteoporosis (1.16, 1.02-1.32) were significantly related to the persistent use of antidepressant. Primary care clinic (0.71, 0.63-0.79), and rural area (0.75, 0.64-0.88) were related to higher risk of non-persistency.
Conclusion: Persistence of SSRIs was low among the elderly. Strategies to improve the persistence were needed.
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KEYWORD
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Antidepressant, Selective serotonin reuptake inhibitor, Persistence, Elderly, Depression, Adherence
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