Every patient, every visit: Routine tests yield clinically useful data
Mining your database can reveal response patterns, improve patient outcomes.
The Carroll Depression Rating Scale (CDRS) is lengthy (52 items), but its self-rating yes/no format makes it easy to administer and score.13 We used the CDRS as the primary outcome measure in a chart review of long-term effectiveness of antidepressant monotherapy in 346 patients with unipolar depression.14
Using baseline and follow-up CDRS scores over 5 years, we examined:
- changes in scores
- which medications most rapidly brought about remission (defined as CDRS score ≤7)
- which medication was most effective in preventing relapse.
We found that sertraline and to a lesser extent paroxetine were more effective than several other antidepressants in achieving remission and preventing relapse.
Logistical concerns
Patient feedback. Although some patients complain about having to complete depression rating scales at every visit, most accept this as equivalent to having routine blood pressure measurements. Many become interested in tracking their improvement by test scores in addition to subjective feelings.
- Multi-Health Systems. Publishers of mental health assessment tools. www.mhs.com.
- Inventory of Depressive Symptomatology (IDS) and Quick Inventory of Depressive Symptomatology (QIDS). www.ids-qids.org.
- Modafinil • Provigil
- Paroxetine • Paxil
- Sertraline • Zoloft
Dr. Nasr is a speaker for Takeda Pharmaceutical Company, Pfizer Inc, Eli Lilly and Company, Bristol-Myers Squibb, Forest Pharmaceuticals, and GlaxoSmithKline.
Acknowledgment
Dr. Nasr acknowledges the contribution of research assistant Burdette J. Wendt, who collects and analyzes the data referenced above and helped prepare this manuscript.
HIPAA. The Health Insurance Portability and Accountability Act (HIPAA) allows publication of large-scale studies that do not identify patients individually. We also obtained permission from the local Institutional Review Board to disseminate non-identifying cumulative data.
