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Adequacy of Pharmacotherapy Among Medicaid-Enrolled Patients Newly Diagnosed with Obsessive-Compulsive Disorder

  • Cheryl S. Hankin, Lorrin M. Koran, Amy Bronstone, Donald W. Black, David V. Sheehan, Eric Hollander, Jeffrey D. Dunn, Larry Culpepper, John Knispel, Darin D. Dougherty and Zhaohui Wang...

Abstract

Objective: To determine the adequacy of pharmacotherapy received by patients with newly-diagnosed obsessive-compulsive disorder (OCD), based on current practice guidelines.

Methods: A 9 year (1997–2006) retrospective claims analysis of adults enrolled in Florida Medicaid for at least 3 continuous years was conducted to determine the percentage who received both a minimally effective duration (≥ 8 continuous weeks) and dose of first-line OCD pharmacotherapy during the year following their first (“index”) OCD diagnosis.

Results: Among 2,960,421 adult (≥ 18 years of age) enrollees, 2,921 (0.1%) were diagnosed with OCD. Among the 2,825 OCD patients without comorbid Asperger syndrome or autism, 843 had newly-diagnosed OCD and at least 12 months of follow-up data after their index diagnosis. Among these 843 patients, 588 (69.7%) received first-line OCD pharmacotherapy but only 323 (38.3%) received a minimally effective pharmacotherapy trial in the year following their index diagnosis.

Conclusions: Among clinically-diagnosed persons with OCD (<10% of those with the disorder), a minority of newly-diagnosed patients receive a minimally effective pharmacotherapy trial consistent with current standards of care. Reasons such as limited patient adherence and/or physician awareness of guidelines must be identified and redressed to ameliorate the patient, healthcare system, and economic burdens associated with OCD.

Copyright

Corresponding author

Please direct all correspondence to: Cheryl S. Hankin, PhD, President and Chief Scientific Officer, BioMedEcon, LLC, P.O. Box 129, Moss Beach, CA 94038; Tel: 650-563-9475, Fax: , 650-563-9485; e-mail: , CHankin@biomedecon.com.

References

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