Patterns and predictors of depression treatment among adults with chronic kidney disease and depression in ambulatory care settings in the United States

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Abstract

Purpose: One in five adults with chronic kidney disease (CKD) in the United States (US) suffers from depression. Comorbid depression in adults with CKD is associated with higher morbidity and mortality. This study used US national survey data to examine patterns and predictors of depression treatment among adults with non-dialysis-dependent CKD in the US. Methods: A retrospective, cross-sectional study was conducted using 2014–2015 National Ambulatory Medical Care Survey (NAMCS) data. The final study sample consisted of visits by 9.02 million adults (unweighted n = 262; age ≥ 18 years) with CKD and depression in the US. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariable logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Results: Approximately half of adults with CKD and depression received depression treatment. Primary care was the main setting of treatment, and the most commonly prescribed antidepressant class was selective serotonin reuptake inhibitors. Adults being seen for treatment of a chronic problem were 3.2 times more likely to receive depression treatment (OR 3.20; 95% CI 1.38–7.21). In addition, there was a 9% higher likelihood of receiving depression treatment for each unit increase in total number of medications (OR 1.09; 95% CI 1.01–1.19). Finally, adults receiving care in the South were 63% less likely to receive depression treatment (OR 0.37; 95% CI 0.15–0.89). Conclusions: Depression treatment was recorded in approximately half of US ambulatory care visits involving adults with CKD and depression from 2014 to 2015. Further research is warranted to determine how to appropriately manage treatment of depression in adults with CKD.

Original languageEnglish (US)
JournalInternational Urology and Nephrology
DOIs
StateAccepted/In press - Jan 1 2018

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Ambulatory Care
Chronic Renal Insufficiency
Depression
Therapeutics
Antidepressive Agents
Health Care Surveys
Serotonin Uptake Inhibitors
Psychotherapy
Causality
Primary Health Care
Cross-Sectional Studies
Logistic Models
Regression Analysis

Keywords

  • Adults
  • Ambulatory care settings
  • Antidepressants
  • Chronic kidney disease
  • Depression

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

@article{f97461949afe4afba5b7b3e620a6f617,
title = "Patterns and predictors of depression treatment among adults with chronic kidney disease and depression in ambulatory care settings in the United States",
abstract = "Purpose: One in five adults with chronic kidney disease (CKD) in the United States (US) suffers from depression. Comorbid depression in adults with CKD is associated with higher morbidity and mortality. This study used US national survey data to examine patterns and predictors of depression treatment among adults with non-dialysis-dependent CKD in the US. Methods: A retrospective, cross-sectional study was conducted using 2014–2015 National Ambulatory Medical Care Survey (NAMCS) data. The final study sample consisted of visits by 9.02 million adults (unweighted n = 262; age ≥ 18 years) with CKD and depression in the US. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariable logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Results: Approximately half of adults with CKD and depression received depression treatment. Primary care was the main setting of treatment, and the most commonly prescribed antidepressant class was selective serotonin reuptake inhibitors. Adults being seen for treatment of a chronic problem were 3.2 times more likely to receive depression treatment (OR 3.20; 95{\%} CI 1.38–7.21). In addition, there was a 9{\%} higher likelihood of receiving depression treatment for each unit increase in total number of medications (OR 1.09; 95{\%} CI 1.01–1.19). Finally, adults receiving care in the South were 63{\%} less likely to receive depression treatment (OR 0.37; 95{\%} CI 0.15–0.89). Conclusions: Depression treatment was recorded in approximately half of US ambulatory care visits involving adults with CKD and depression from 2014 to 2015. Further research is warranted to determine how to appropriately manage treatment of depression in adults with CKD.",
keywords = "Adults, Ambulatory care settings, Antidepressants, Chronic kidney disease, Depression",
author = "Nina Vadiei and Sandipan Bhattacharjee",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s11255-018-2034-3",
language = "English (US)",
journal = "International Urology and Nephrology",
issn = "0301-1623",
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}

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T1 - Patterns and predictors of depression treatment among adults with chronic kidney disease and depression in ambulatory care settings in the United States

AU - Vadiei, Nina

AU - Bhattacharjee, Sandipan

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: One in five adults with chronic kidney disease (CKD) in the United States (US) suffers from depression. Comorbid depression in adults with CKD is associated with higher morbidity and mortality. This study used US national survey data to examine patterns and predictors of depression treatment among adults with non-dialysis-dependent CKD in the US. Methods: A retrospective, cross-sectional study was conducted using 2014–2015 National Ambulatory Medical Care Survey (NAMCS) data. The final study sample consisted of visits by 9.02 million adults (unweighted n = 262; age ≥ 18 years) with CKD and depression in the US. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariable logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Results: Approximately half of adults with CKD and depression received depression treatment. Primary care was the main setting of treatment, and the most commonly prescribed antidepressant class was selective serotonin reuptake inhibitors. Adults being seen for treatment of a chronic problem were 3.2 times more likely to receive depression treatment (OR 3.20; 95% CI 1.38–7.21). In addition, there was a 9% higher likelihood of receiving depression treatment for each unit increase in total number of medications (OR 1.09; 95% CI 1.01–1.19). Finally, adults receiving care in the South were 63% less likely to receive depression treatment (OR 0.37; 95% CI 0.15–0.89). Conclusions: Depression treatment was recorded in approximately half of US ambulatory care visits involving adults with CKD and depression from 2014 to 2015. Further research is warranted to determine how to appropriately manage treatment of depression in adults with CKD.

AB - Purpose: One in five adults with chronic kidney disease (CKD) in the United States (US) suffers from depression. Comorbid depression in adults with CKD is associated with higher morbidity and mortality. This study used US national survey data to examine patterns and predictors of depression treatment among adults with non-dialysis-dependent CKD in the US. Methods: A retrospective, cross-sectional study was conducted using 2014–2015 National Ambulatory Medical Care Survey (NAMCS) data. The final study sample consisted of visits by 9.02 million adults (unweighted n = 262; age ≥ 18 years) with CKD and depression in the US. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariable logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Results: Approximately half of adults with CKD and depression received depression treatment. Primary care was the main setting of treatment, and the most commonly prescribed antidepressant class was selective serotonin reuptake inhibitors. Adults being seen for treatment of a chronic problem were 3.2 times more likely to receive depression treatment (OR 3.20; 95% CI 1.38–7.21). In addition, there was a 9% higher likelihood of receiving depression treatment for each unit increase in total number of medications (OR 1.09; 95% CI 1.01–1.19). Finally, adults receiving care in the South were 63% less likely to receive depression treatment (OR 0.37; 95% CI 0.15–0.89). Conclusions: Depression treatment was recorded in approximately half of US ambulatory care visits involving adults with CKD and depression from 2014 to 2015. Further research is warranted to determine how to appropriately manage treatment of depression in adults with CKD.

KW - Adults

KW - Ambulatory care settings

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KW - Chronic kidney disease

KW - Depression

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