Use and Unintended Consequences of Antidepressant Medications by Depressed Older Adults
In: Open Access Dissertations, 2013
academicJournal
Zugriff:
Background National guidelines suggest 12-18 months of antidepressant treatment for depressed patients to maximize the benefits of treatment; however, patterns of medication use according to the guidelines are less well understood, especially in older adults who are at higher risk of adverse drug events. In addition, selective serotonin reuptake inhibitors (SSRIs) are recommended as a first-line therapy for older adults because of their favorable adverse event profile; however, several observational studies have suggested an association between SSRI use and an increased risk of gastrointestinal (GI) bleeding. While this link remains controversial, it is important to evaluate the risk of GI bleeding in association with SSRI use, especially in older adults who take multiple medications that may increase the risk of GI bleeding. Objectives The purpose of this dissertation is to describe the patterns of antidepressant medication use by older adults and quantify the adverse events associated with antidepressant use. The third manuscript focuses on methodology to perform a systematic literature review of published articles reporting effect measure modification (EMM) and characterize the sample size considerations related to EMM. Methods In the first manuscript, we performed a cross-sectional study using the Medicare Current Beneficiary Survey (MCBS) data from 2004 to 2008. We estimated a 6-month discontinuation rate of antidepressant medications in older adults who initiated antidepressant treatment following diagnosis with depression. We further developed a multivariable logistic regression model to identify predictors of discontinuation of antidepressant medication. For the second manuscript, we conducted a nested case-control study using the MCBS data from 2004-2008. We identified cases as all older adults diagnosed with upper GI bleeding. Using incidence density sampling, we randomly selected up to 6 controls who had no evidence of upper GI bleeding after matching on age (+/- 5 years), gender, calendar year, and ...
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Use and Unintended Consequences of Antidepressant Medications by Depressed Older Adults
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Autor/in / Beteiligte Person: | Noh, Eun Sun |
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Zeitschrift: | Open Access Dissertations, 2013 |
Veröffentlichung: | DigitalCommons@URI, 2013 |
Medientyp: | academicJournal |
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