Correlation of antidepressant target dose optimization and achievement of glycemic control.
| Autor: | Grisham-Takac C; PGY2 Ambulatory Care Resident (at time of study), CommUnityCare Health Centers/University of Texas at Austin College of Pharmacy, Austin, Texas, catlin.grisham-takac@communitycaretx.org., Lai P; Medical Science Liason, Otsuka Pharmaceuticals Development and Commercialization, Austin, Texas., Srinivasa M; Clinical Pharmacist, CommUnityCare Health Centers/University of Texas at Austin College of Pharmacy, Austin, Texas., Vasquez L; Clinical Pharmacist and Associate Residency Program Director, CommUnityCare Health Centers/University of Texas at Austin College of Pharmacy, Austin, Texas., Rascati KL; Professor, University of Texas at Austin College of Pharmacy, Austin, Texas. |
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| Jazyk: | angličtina |
| Zdroj: | The mental health clinician [Ment Health Clin] 2019 Jan 04; Vol. 9 (1), pp. 12-17. Date of Electronic Publication: 2019 Jan 04 (Print Publication: 2019). |
| DOI: | 10.9740/mhc.2019.01.012 |
| Abstrakt: | Introduction: Depression is a recognized cause of disability globally with a propensity to be comorbid in patients with diabetes, leading to poorer health-related outcomes. Although a number of studies have investigated the correlation between improvement in depression and chronic disease, none have reported on achievement of target doses of antidepressant therapies and diabetes control. The objective of this study is to determine the influence of antidepressant dosing optimization on reducing hemoglobin A1c (HbA1c). Methods: This was a retrospective cohort study of patients seen at CommUnityCare Health Centers who were initiated on an antidepressant and had uncontrolled diabetes (HbA1c > 7%). Eligible patients were followed for 12 months after initiation and separated into those who achieved target dose and those who did not. Patient health questionnaire scores were collected when available in an attempt to quantify change in depressive symptoms. Results: A total of 178 patients met inclusion criteria with 76 achieving an optimal dose (target group) and 102 patients below optimal dose (control group) at the end of the study period. Patients in both groups were similar at baseline with an HbA1c of 9.29% compared to 9.24% in the target and control groups, respectively. At the end of the study period, more patients in the target group achieved an HbA1c < 7% (22.9%, n = 48 vs 4.3%, n = 23, respectively; P < .05). Discussion: These results suggest that optimization of antidepressant dosing in patients with diabetes may lead to an increased likelihood of reaching goal HbA1c < 7% although correlation to improvement of depression remains unknown. Competing Interests: Disclosures: P.L. was a clinical pharmacist with CommUnityCare during the development, data-analysis, and manuscript production for this research. His contributions to this publication are his own and were not performed on behalf of his current employer (Otsuka Pharmaceuticals). P.L. and the remaining authors have no other conflicts of interest to disclose. |
| Databáze: | MEDLINE |
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