| Undertreatment of panic disorder in primary care: role of patient and physician characteristics. | |
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MedLine Citation:
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PMID: 12463289 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In contrast with many studies describing the usual care for major depression in the primary care setting, there are few data on treatment received by primary care patients with panic disorder. METHODS: This prospective cohort study describes the self-reported medication use, at 3-month intervals for 1 year, of 58 patients with panic disorder and predictors of the use of appropriate (type, dose, and duration) medication. RESULTS: Approximately one half the patients received some type of antipanic medication at each interval, with selective serotonin reuptake inhibitors (SSRIs) the most common. Pharmacy records indicate that about 40% of patients not taking medication had received an initial physician prescription. Adequacy of dose and duration was achieved in only two thirds of the medication trials, usually with an SSRI. Patient characteristics (agoraphobia and low neuroticism) but not physician characteristics (eg, specialty, level of training, or years in practice) predicted those patients who had an adequate trial during at least one time interval. The relation between adequacy of medication and outcome was minimal. CONCLUSION: These findings highlight the continued undertreatment of panic disorder in primary care but suggest that focused efforts at physician education about diagnosis and treatment are less likely to increase rates of treatment compared with efforts to educate patients and improve the care process with more frequent visits and monitoring. |
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Authors:
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Peter Roy-Byrne; Joan Russo; David C Dugdale; Daniel Lessler; Deborah Cowley; Wayne Katon |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Journal of the American Board of Family Practice / American Board of Family Practice Volume: 15 ISSN: 0893-8652 ISO Abbreviation: J Am Board Fam Pract Publication Date: 2002 Nov-Dec |
Date Detail:
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Created Date: 2002-12-04 Completed Date: 2003-03-04 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8807505 Medline TA: J Am Board Fam Pract Country: United States |
Other Details:
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Languages: eng Pagination: 443-50 Citation Subset: IM |
Affiliation:
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Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, Seattle 98104-2499, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Demography Drug Utilization / statistics & numerical data* Female Health Services Misuse Humans Male Middle Aged Panic Disorder / drug therapy* Physician's Practice Patterns / statistics & numerical data* Primary Health Care / standards* Serotonin Uptake Inhibitors / therapeutic use* Treatment Outcome Washington |
| Grant Support | |
ID/Acronym/Agency:
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MH 016343/MH/NIMH NIH HHS; MH 57858/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Serotonin Uptake Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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