Document Detail


Undertreatment of panic disorder in primary care: role of patient and physician characteristics.
MedLine Citation:
PMID:  12463289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Peter Roy-Byrne; Joan Russo; David C Dugdale; Daniel Lessler; Deborah Cowley; Wayne Katon
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
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:
Created Date:  2002-12-04     Completed Date:  2003-03-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8807505     Medline TA:  J Am Board Fam Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  443-50     Citation Subset:  IM    
Affiliation:
Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, Seattle 98104-2499, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
MH 016343/MH/NIMH NIH HHS; MH 57858/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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