TY - JOUR
T1 - Receipt of Treatment for Depression following Traumatic Brain Injury
AU - Albrecht, Jennifer S.
AU - Abariga, Samuel A.
AU - Dosreis, Susan
AU - Perfetto, Eleanor M.
AU - Mullins, C. Daniel
AU - Rao, Vani
AU - Albrecht, Jennifer S.
N1 - Funding Information:
Dr Albrecht is supported by Agency for Healthcare Quality and Research grant K01HS024560 and receives funding for investigator-initiated research from ResMed and the American Academy of Sleep Medicine Foundation. Dr Rao is supported by PCORI grant 7136(JHU). Dr Perfetto is employed by the National Health Council in Washington, District of Columbia, which accepts membership dues and sponsorships from a variety of organizations and companies. For the full list of members and sponsors, see NHCouncil.org. No competing financial interests exist.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objective: Lack of evidence for efficacy and safety of treatment and limited clinical guidance have increased potential for undertreatment of depression following traumatic brain injury (TBI). Methods: We conducted a retrospective cohort study among individuals newly diagnosed with depression from 2008 to 2014 to assess the impact of TBI on receipt of treatment for incident depression using administrative claims data. We created inverse probability of treatment-weighted populations to evaluate the impact of TBI on time to receipt of antidepressants or psychotherapy following new depression diagnosis during 24 months post-TBI or matched index date (non-TBI cohort). Results: Of 10 428 individuals with incident depression in the TBI cohort, 44.7% received 1 or more antidepressants and 20.0% received 1 or more psychotherapy visits. Of 10 463 in the non-TBI cohort, 41.2% received 1 or more antidepressants and 17.6% received 1 or more psychotherapy visits. TBI was associated with longer time to receipt of antidepressants compared with the non-TBI cohort (average 39.6 days longer than the average 126.2 days in the non-TBI cohort; 95% confidence interval [CI], 24.6-54.7). Longer time to psychotherapy was also observed among individuals with TBI at 6 months post-TBI (average 17.1 days longer than the average 47.9 days in the non-TBI cohort; 95% CI, 4.2-30.0), although this association was not significant at 12 and 24 months post-TBI. Conclusions: This study raises concerns about the management of depression following TBI.
AB - Objective: Lack of evidence for efficacy and safety of treatment and limited clinical guidance have increased potential for undertreatment of depression following traumatic brain injury (TBI). Methods: We conducted a retrospective cohort study among individuals newly diagnosed with depression from 2008 to 2014 to assess the impact of TBI on receipt of treatment for incident depression using administrative claims data. We created inverse probability of treatment-weighted populations to evaluate the impact of TBI on time to receipt of antidepressants or psychotherapy following new depression diagnosis during 24 months post-TBI or matched index date (non-TBI cohort). Results: Of 10 428 individuals with incident depression in the TBI cohort, 44.7% received 1 or more antidepressants and 20.0% received 1 or more psychotherapy visits. Of 10 463 in the non-TBI cohort, 41.2% received 1 or more antidepressants and 17.6% received 1 or more psychotherapy visits. TBI was associated with longer time to receipt of antidepressants compared with the non-TBI cohort (average 39.6 days longer than the average 126.2 days in the non-TBI cohort; 95% confidence interval [CI], 24.6-54.7). Longer time to psychotherapy was also observed among individuals with TBI at 6 months post-TBI (average 17.1 days longer than the average 47.9 days in the non-TBI cohort; 95% CI, 4.2-30.0), although this association was not significant at 12 and 24 months post-TBI. Conclusions: This study raises concerns about the management of depression following TBI.
KW - administrative claims data
KW - antidepressants
KW - depression treatment
KW - psychotherapy
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85090491069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090491069&partnerID=8YFLogxK
U2 - 10.1097/HTR.0000000000000558
DO - 10.1097/HTR.0000000000000558
M3 - Article
C2 - 32108708
AN - SCOPUS:85090491069
SN - 0885-9701
VL - 35
SP - E429-E435
JO - Journal of Head Trauma Rehabilitation
JF - Journal of Head Trauma Rehabilitation
IS - 5
ER -