TABLE 1.
Baseline Distribution of Characteristics Between Inappropriate and Appropriate Antidepressant Initiators in Medicare 5% Sample Claims Data (2012–2013)
| Overall | Inappropriate Antidepressant Initiators | Appropriate Antidepressant Initiators | χ2 | df | p Value | ||||
|---|---|---|---|---|---|---|---|---|---|
| N | % | N | % | N | % | ||||
| Age groupa | 10.526 | 1 | 0.001 | ||||||
| 65–74 years | 1,183 | 15.5 | 117 | 9.9 | 1,066 | 90.1 | |||
| 75+ years | 6,442 | 84.5 | 462 | 7.2 | 5,980 | 92.8 | |||
| Gender | 0.897 | 1 | 0.344 | ||||||
| Male | 1,970 | 25.8 | 140 | 7.1 | 1,830 | 92.9 | |||
| Female | 5,655 | 74.2 | 439 | 7.8 | 5,216 | 92.2 | |||
| Race/ethnicity | 0.020 | 1 | 0.887 | ||||||
| White | 6,795 | 89.1 | 517 | 7.6 | 6,278 | 92.4 | |||
| Other | 830 | 10.9 | 62 | 7.5 | 768 | 92.5 | |||
| Public assistance | 0.007 | 1 | 0.933 | ||||||
| Yes | 2,356 | 30.9 | 178 | 7.6 | 2,178 | 92.4 | |||
| No | 5,269 | 69.1 | 401 | 7.6 | 4,868 | 92.4 | |||
| Region | 8.638 | 3 | 0.035 | ||||||
| Northeast | 1,549 | 20.3 | 106 | 6.8 | 1,443 | 93.2 | |||
| South | 3,116 | 40.9 | 270 | 8.7 | 2,846 | 91.3 | |||
| Midwest | 2,073 | 27.2 | 143 | 6.9 | 1,930 | 93.1 | |||
| West | 887 | 11.6 | 60 | 6.8 | 827 | 93.2 | |||
| Metropolitan status | 3.328 | 1 | 0.068 | ||||||
| Yes | 6,046 | 79.3 | 442 | 7.3 | 5,604 | 92.7 | |||
| No | 1,579 | 20.7 | 137 | 8.7 | 1,442 | 91.3 | |||
| Baseline Parkinson disease | 0.396 | 1 | 0.529 | ||||||
| Yes | 455 | 6.0 | 38 | 8.4 | 417 | 91.6 | |||
| No | 7,170 | 94.0 | 541 | 7.5 | 6,629 | 92.5 | |||
| Baseline psychotherapy | 5.418 | 1 | 0.020 | ||||||
| Yes | 930 | 12.2 | 53 | 5.7 | 877 | 94.3 | |||
| No | 6,695 | 87.8 | 526 | 7.9 | 6,169 | 92.1 | |||
| Provider specialty | 12.500 | 4 | 0.014 | ||||||
| General Family | 5,774 | 75.7 | 439 | 7.6 | 5,335 | 92.4 | |||
| Neurology | 176 | 2.3 | 16 | 9.1 | 160 | 90.9 | |||
| Psychiatry | 426 | 5.6 | 23 | 5.4 | 403 | 94.6 | |||
| Other | 1,085 | 14.2 | 97 | 8.9 | 988 | 91.1 | |||
| Unknown | 164 | 2.2 | 4 | 2.4 | 160 | 97.6 | |||
| Density of neurologists | 7.691 | 3 | 0.053 | ||||||
| 0 | 1,503 | 19.7 | 131 | 8.7 | 1,372 | 91.3 | |||
| 1 | 2,040 | 26.8 | 162 | 7.9 | 1,878 | 92.1 | |||
| 2 | 2,059 | 27.0 | 158 | 7.7 | 1,901 | 92.3 | |||
| 3 | 2,023 | 26.5 | 128 | 6.3 | 1,895 | 93.7 | |||
| Density of psychiatrists | 8.202 | 3 | 0.042 | ||||||
| 0 | 1,119 | 14.7 | 96 | 8.6 | 1,023 | 91.4 | |||
| 1 | 2,137 | 28.0 | 184 | 8.6 | 1,953 | 91.4 | |||
| 2 | 2,200 | 28.9 | 150 | 6.8 | 2,050 | 93.2 | |||
| 3 | 2,169 | 28.4 | 149 | 6.9 | 2,020 | 931 | |||
| ELX Index | 8.474 | 3 | 0.037 | ||||||
| 0 | 1,248 | 16.4 | 118 | 9.5 | 1,130 | 90.5 | |||
| 1 | 1,198 | 15.7 | 90 | 7.5 | 1,108 | 92.5 | |||
| 2 | 1,163 | 15.3 | 91 | 7.8 | 1,072 | 92.2 | |||
| ≥3 | 4,016 | 52.7 | 280 | 7.0 | 3,736 | 93.0 | |||
| Baseline medication use ACE inhibitors | 2.277 | 1 | 0.131 | ||||||
| Yes | 1,908 | 25.0 | 160 | 8.4 | 1,748 | 91.6 | |||
| No | 5,717 | 75.0 | 419 | 7.3 | 5,298 | 92.7 | |||
| Anticoagulants | 0.355 | 1 | 0.551 | ||||||
| Yes | 915 | 12.0 | 65 | 7.1 | 850 | 92.9 | |||
| No | 6,710 | 88.0 | 514 | 7.7 | 6,196 | 92.3 | |||
| Antidiabetic | 1.030 | 1 | 0.310 | ||||||
| Yes | 1,344 | 17.6 | 111 | 8.3 | 1,233 | 91.7 | |||
| No | 6,281 | 82.4 | 468 | 7.5 | 5,813 | 92.5 | |||
| Antiparkinsonian | 1.061 | 1 | 0.303 | ||||||
| Yes | 499 | 6.5 | 32 | 6.4 | 467 | 93.6 | |||
| No | 7,126 | 93.5 | 547 | 7.7 | 6,579 | 92.3 | |||
| Antipsychotic | 5.924 | 1 | 0.015 | ||||||
| Yes | 1,220 | 16.0 | 72 | 5.9 | 1,148 | 94.1 | |||
| No | 6,405 | 84.0 | 507 | 7.9 | 5,898 | 92.1 | |||
| Anxiolytica | 8.124 | 1 | 0.004 | ||||||
| Yes | 1,270 | 16.7 | 121 | 9.5 | 1,149 | 90.5 | |||
| No | 6,355 | 83.3 | 458 | 7.2 | 5,897 | 92.8 | |||
| ARBs | 3.237 | 1 | 0.072 | ||||||
| Yes | 988 | 13.0 | 89 | 9.0 | 899 | 91.0 | |||
| No | 6,637 | 87.0 | 490 | 7.4 | 6,147 | 92.6 | |||
| Statins | 3.158 | 1 | 0.076 | ||||||
| Yes | 2,717 | 35.6 | 226 | 8.3 | 2,491 | 91.7 | |||
| No | 4,908 | 64.4 | 353 | 7.2 | 4,555 | 92.8 | |||
| PPIs | 0.022 | 1 | 0.883 | ||||||
| Yes | 2,284 | 30.0 | 175 | 7.7 | 2,109 | 92.3 | |||
| No | 5,341 | 70.0 | 404 | 7.6 | 4,937 | 92.4 | |||
| Beta-blockers | 0.104 | 1 | 0.747 | ||||||
| Yes | 2,998 | 39.3 | 224 | 7.5 | 2,774 | 92.5 | |||
| No | 4,627 | 60.7 | 355 | 7.7 | 4,272 | 92.3 | |||
| CCB | 0.403 | 1 | 0.526 | ||||||
| Yes | 1,794 | 23.5 | 130 | 7.2 | 1,664 | 92.8 | |||
| No | 5,831 | 76.5 | 449 | 7.7 | 5,382 | 92.3 | |||
| Diuretic | 0.096 | 1 | 0.756 | ||||||
| Yes | 2,679 | 35.1 | 200 | 7.5 | 2,479 | 92.5 | |||
| No | 4,946 | 64.9 | 379 | 7.7 | 4,567 | 92.3 | |||
Notes: Analysis based on 7,625 older adults with dementia and newly diagnosed major depression. At least one potentially inappropriate antidepressant was initiated by 579 (7.59%) older adults in this study sample. Results are based on the χ2 test analysis. For density of neurologists and psychiatrists, the category 0 represents zero neurologists/psychiatrists in the zip code and the categories 1, 2, and 3 represents the first, second, and third tertiles, respectively, of nonzero densities. ACE: angiotensin converting enzyme; ARBs: angiotensin receptor blockers; CCB: calcium channel blockers; ELX: Elixhauser; PPIs: proton pump inhibitors.
Represents statistical significance (p <0.01).