Antidepressant compliance rates of Optima Health members are well below the national averages, as are rates for the entire South Atlantic area.

Less than 60% of the commercial population continues their antidepressants for 3 months while only 40% remain on antidepressants for 6 months.  Only 35% of the Medicaid population continue on their antidepressant for 3 months, while barely 20% continue treatment for 6 months.

Sentara Behavioral Health Services and Optima Health are taking an active role by educating our members and incorporating depression management policies into all of the chronic disease management programs. However there is only so much we can do organizationally.

The real key lies in the relationship you have with patients being treated for depression, both in terms of education, monitoring and encouragement.

Recent evidence from the National Institute of Mental Health (NIMH) funded STAR*D trial reinforces the effectiveness of what we already know:

• See patients frequently during the early phase of antidepressant treatment. Patients who did best in the study were seen an average of 6 times in the first 3 months of treatment.
• Remind your patients how critical it is to hang in there! In the STAR*D study, it generally took patients at least 6 to 7 weeks to reach remission, and for some it took as long as 14 weeks to reach remission.
• Side effects account for as many as two-thirds of all pre-mature discontinuations of antidepressants. Coach your patients through the side effects that tend to occur before the therapeutic effects-most side effects are early onset and time limited (for example, SSRI induced, nausea, diarrhea, agitation, anxiety, and headache).  These can be managed by temporary aids to tolerance.

Contact our Quality Improvement department with your suggestions on how we can work together more effectively to make sure Optima Health members with depression get the full benefit of their treatment.