| Abstrakt: |
OBJECTIVE: The purpose of this study was to assess the impact of commonly applied research selection criteria on the proportion of patients initiated on fluoxetine, paroxetine, or sertraline who received only the initial agent, at the same dose, for 90 or more continuous days. METHODS: This retrospective utilization analysis of a large U.S. prescription claims database grouped patients initiating on fluoxetine, paroxetine, or sertraline into samples with (typical design, n = 17,825) and without (relaxed design, n = 291,758) commonly applied research selection criteria. Patients selected were 18 or older and eligible during the respective review periods. Patients in the typical design had no prior period use of antidepressants and no use of other psychotropics. Patients who maintained 90 or more continuous days of therapy exclusively on their initial study drug and who did not experience dose escalation were assigned a stable utilization pattern. All others were assigned a non-stable utilization pattern. RESULTS: The typical design had significantly (p ≤ 0.001) fewer patients with a stable utilization pattern (29% typical, 32% relaxed). The percentage of patients achieving a stable utilization pattern with fluoxetine was at least five percentage points greater, a significant (p ≤ 0.001) difference, than the percentage for either paroxetine or sertraline. The stable pattern was significantly more likely for sertraline than paroxetine patients in the relaxed design (29.7%, 29.1%, p = 0.017) but not in the typical design (26.5%, 26.6%, p = 0.920). CONCLUSIONS: A stable utilization pattern is more likely with fluoxetine than with paroxetine or sertraline initiated patients. The stable pattern's relative relationship is robust across designs for fluoxeotine but not for paroxetine and sertraline. |
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