Current FDA guidelines for both pediatric and adult patients recommend at least weekly face-to-face visits with a health practitioner during the first four weeks of antidepressant treatment, then every other week during the next four weeks, and then a visit after 12 weeks. However, according to the results of the study, nearly half of all patients have no follow-up visits during the first month of taking antidepressants, and fewer than 18% of patients see a practitioner specifically for mental health follow-up care during that time period.
The new study, results of which were published in the American Journal of Managed Care, found that few patients were monitored closely during the first three months following the start of antidepressant therapy. The study, which reviewed medical and pharmacy claims of 84,500 pediatric and adult patients, found that less than 15% of patients received the FDA’s current recommended level of follow-up care in the first four weeks of drug treatment, 18% at eight weeks, and 23% at 12 weeks.
“This study brings to light potentially serious inadequacies in the follow-up care of patients on antidepressants,” said Dr Glen Stettin, senior vice president of clinical solutions for Medco and lead author of the study. “Not only is close monitoring needed to reduce the risk of adverse outcomes including suicidal tendencies, but also to assess a patient’s response to the treatment, make adjustments to drug dosages when necessary and help manage side-effects that can lead to poor compliance or the discontinuation of therapy, which can have extremely negative consequences as well.”
While fewer than half of children 18 years and younger saw a practitioner at least once for mental health care follow-up in the first few months of antidepressant treatment, adult visits were even less frequent. Indeed, the study revealed that 66% of children and 83% of adults did not see a clinician for a mental health care visit in the first four weeks after antidepressant therapy had begun.
Furthemore, 58% of children and 78% of adults had not had such a visit within eight weeks, and 53% of children and nearly 76% of adult patients had no mental health care visits during the first 12 weeks of drug therapy.
While the study found that general medical visits were more common than mental health care visits in the first few weeks and months of antidepressant treatment, still 45% of patients saw no health clinician at all in the first four weeks of drug therapy, more than 30% did not see a health provider within eight weeks and 23% had no medical visits at all within 12 weeks.