Treatment adherence and persistence with duloxetine, venlafaxine XR, and escitalopram among patients with major depressive disorder and chronic pain-related diseases

Author： Wang Junling   Liu Xianchen   Mullins C. Daniel  

Publisher： Informa Healthcare

ISSN： 1473-4877

Source： Current Medical Research and Opinion, Vol.27, Iss.7, 2011-07, pp. : 1303-1313

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

Abstract Objective:Chronic pain is prevalent in patients with major depressive disorder (MDD). This study compared adherence and persistence rates among MDD patients with comorbid chronic pain-related diseases (CPD, including fibromyalgia, diabetes with neurological manifestations, osteoarthritis, low back pain, and headache) for three antidepressants: duloxetine, venlafaxine XR, and escitalopram. Research design and methods:A retrospective analysis was conducted of 15,523 adult MDD patients with CPD in the MarketScan Commercial Claims and Encounters Database who started on one of the study medications between 07/01/06 and 06/30/07. Patients were followed-up for 6 months. Adherence was reported using a medication possession ratio ≥≥0.8. Persistence was measured using persistence rates (proportions of patients who continuously refilled prescriptions during 6 months) and duration of therapy (number of days patients remained on the study medication before a prescription gap over 30 days). Multivariate logistic regression on adherence and persistence rates and linear regression on duration of therapy adjusting for patient and prescription characteristics were conducted. Results:Patients on duloxetine had a higher adherence rate (46.03%%) than those on venlafaxine XR (42.94%%; p == 0.0033) or escitalopram (37.27%%; p < 0.0001). Patients on duloxetine also had a higher persistence rate and longer duration of therapy (43.66%%, 117.82 days) than did patients treated with venlafaxine XR (40.38%%; p == 0.0017; 114.24 days; p == 0.009) or escitalopram (33.86%%; p < 0.0001; 105.73 days; p < 0.0001). These differences were still significant after adjusting for patient and prescription characteristics (p < 0.05). Sensitivity analyses found similar patterns using an allowable gap for refill of 15 days. Conclusions:Among commercially insured MDD patients with CPD, duloxetine-treated patients had higher adherence and persistence rates than did patients treated with venlafaxine XR or escitalopram during 6 months after medication initiation. Future studies should examine the clinical and economic implications of these differences. Limitations:This study has limitations such as possible selection bias using secondary database analysis.

Related content

Cost effectiveness of duloxetine compared with venlafaxine-XR in the treatment of major depressive disorder

By van Baardewijk M.   Vis P. M. J.   Einarson T. R.  

Current Medical Research and Opinion, Vol. 21, Iss. 8, 2005-08 ,pp. : 1271-1280 (10)

Informa Healthcare

Access to resources Recommend Favorite

A Markov cost-utility analysis of escitalopram and duloxetine for the treatment of major depressive disorder

By Armstrong Edward P.   Malone Daniel C.   Erder M. Haim  

Current Medical Research and Opinion, Vol. 24, Iss. 4, 2008-04 ,pp. : 1115-1121 (7)

Informa Healthcare

Access to resources Recommend Favorite

A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder

By Wade A.   Gembert K.   Florea I.  

Current Medical Research and Opinion, Vol. 23, Iss. 7, 2007-07 ,pp. : 1605-1614 (10)

Informa Healthcare

Access to resources Recommend Favorite

Duloxetine versus escitalopram and placebo in the treatment of patients with major depressive disorder: onset of antidepressant action, a non-inferiority study

By Nierenberg Andrew A.   Greist John H.   Mallinckrodt Craig H.   Prakash Apurva   Sambunaris Angelo   Tollefson Gary D.   Wohlreich Madelaine M.  

Current Medical Research and Opinion, Vol. 23, Iss. 2, 2007-02 ,pp. : 401-416 (16)

Informa Healthcare

Access to resources Recommend Favorite

Comparison of treatment persistence, hospital utilization and costs among major depressive disorder geriatric patients treated with escitalopram versus other SSRI/SNRI antidepressants

By Wu Eric   Greenberg Paul   Yang Elaine   Yu Andrew   Ben-Hamadi Rym   Erder M. Haim  

Current Medical Research and Opinion, Vol. 24, Iss. 10, 2008-10 ,pp. : 2805-2813 (9)

Informa Healthcare

Access to resources Recommend Favorite