Treatment patterns, healthcare resource utilization, and costs following first-line antidepressant treatment in major depressive disorder: a retrospective US claims database analysis

Table 1 First pharmacotherapy change definition

Pharmacotherapy change^a	Definition
Discontinuation	Interruption of ≥42 consecutive days of the drug regimen initiated at the beginning of the line of therapy
Dose escalation	Increase in daily dose of ≥50% compared to prior dose - A dose escalation occurring during the first 21 days was not considered in analyses as this was likely due to titration for tolerability reasons.
Switch^b	Initiation of a new drug regimen (antidepressant and/or atypical antipsychotic) within 42 days of the discontinuation of the drug regimen initiated at the beginning of the line of therapy - Patients on combination therapy at the beginning of a line of therapy who discontinued one treatment but remained on the other treatment were deemed to have switched to a new drug regimen.
Persistence	Absence of any of the treatment changes until the end of the study period
Combination	Treatment add-on resulting in the use of ≥2 antidepressants simultaneously.
Augmentation	Treatment add-on resulting in the use of one antidepressant and an atypical antipsychotic simultaneously.

^aSubsequent pharmacotherapy changes (second through fourth) were identified in a similar manner, and also included switch/drop (i.e., in combination and augmentation cohorts only, this represented a change in the overall drug regimen); and resumption of pharmacotherapy (i.e., initiation of a new drug regimen or re-initiation of the same drug regimen following discontinuation)
^bFor antidepressants, the analysis was performed at the active ingredient level, i.e., a change from a branded to a generic form of the same active ingredient was not considered as a switch. A switch from an atypical antipsychotic to another atypical antipsychotic was not considered

ISSN: 1471-244X