241702 Depression treatment among elderly cancer patients

Wednesday, November 2, 2011

Chan Shen, PhD , Economics, Georgetown University, Washington, DC
Patricia A. Findley, DrPH, MSW , School of Social Work, Rutgers,The State University of New Jersey, New Brunswick, NJ
Usha Sambamoorthi, PhD , Pharmaceutical Systems and Policy, School of Pharmacy, Morgantown, WV
BACKGROUND: We examine depression treatment patterns among elderly with cancer and analyze its association with demographic, socio-economic characteristics and health status. METHODS: A cross-sectional design with merged data from Medicare Current Beneficiary Survey(MCBS) annually from 2000-2005 and Medicare fee-for-service claims. Depression was based on ICD-9-CM codes. Antidepressant use was identified from self-reports; psychotherapy visits were extracted using current procedural terminology codes. Among all individuals with cancer and depression, we categorized depression treatment into three groups: 1) antidepressants only; 2) psychotherapy with or without antidepressant; and 3) no depression treatment. Chi-square tests and multinomial logistic regressions were performed to analyze the association between depression treatment and demographic, socio-economic characteristics and health status. All analyses accounted for complex survey design of the MCBS. STUDY SAMPLE: Medicare beneficiaries who reported they were ever told they had cancer and were diagnosed with depression (N = 865) were included. RESULTS: Overall,57% of the sample had antidepressant treatment only;19% had psychotherapy with or without antidepressant; and24% had no depression treatment. Multinomial logistic regression revealed non-white and those with less than high school education were less likely to receive antidepressants and/or psychotherapy. Those living in non-metropolitan areas were less likely to receive treatment for depression. CONCLUSIONS: Our study documented very low rates of psychotherapy among elderly with cancer. We found disparities in depression treatment in non-white and less educated groups. Policy and clinical efforts should focus on reasons for such low rates of treatment and develop interventions to reduce and ultimately eliminate racial disparities in depression treatment.

Learning Areas:
Advocacy for health and health education
Chronic disease management and prevention
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Program planning
Public health or related nursing

Learning Objectives:
1. Participants will describe disparities in depression treatment among elderly Medicare beneficiaries 2. Participants will explain policy implications for the identified disparities

Keywords: Cancer, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health economist and have worked with large data sets focused on elderly populations for several years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.