Racial disparities in prescription of antidepressants among U.S. veterans referred to behavioral health care
APA Citation:
Remmert, J. E., Guzman, G., Mavandadi, S., & Oslin, D. (2022). Racial disparities in prescription of antidepressants among U.S. veterans referred to behavioral health care. Psychiatric Services, 73(9), 984-990. https://doi.org/10.1176/appi.ps.202100237
Focus:
Veterans
Substance use
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Subject Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Authors:
Remmert, Jocelyn E., Guzman, Gabriella, Mavandadi, Shahrzad, Oslin, Dave
Abstract:
Objective: Antidepressants are often prescribed in primary care to treat veterans who have depression. An evaluation of current racial disparities in integrated primary care is warranted. This study examined the association between race and prescription of antidepressants among veterans in primary care. Methods: Veterans in primary care (Black, N=4,120; White, N=4,372) who were referred from primary care to a collaborative care program completed an assessment of demographic characteristics and clinical symptoms, including of current antidepressant prescription before the referral, verified by chart review. Patient data were collected from January 1, 2015, to December 22, 2020. Logistic regression analyses were conducted to examine the relationships between patient race and both depression symptoms and antidepressant prescription. Analyses were also stratified by severity of depression symptoms to understand the results in the context of clinical guidelines. Results: White patients were almost two times (odds ratio=1.96, 95% confidence interval [CI]=1.75–2.19, p<0.001) more likely than Black patients to receive an antidepressant prescription, after the analysis was controlled for depression symptoms, demographic characteristics, and other clinical symptoms. Among patients with severe depression, for whom prescription of antidepressants is clinically indicated, White patients were 1.87 times more likely than Black patients to receive an antidepressant prescription (95% CI=1.40–2.50, p<0.001). Conclusions: The findings reveal racial disparities in antidepressant prescription for veterans in primary care. Regular clinical review of antidepressant prescription is recommended to identify disparities in individual clinics. Future research should aim to identify drivers of racial disparities and provide recommendations for health care systems, providers, and patients.
Publication Type:
Article
Keywords:
antidepressants, depression, primary care, racial-ethnic disparities