Evidence map›Paper›PMID 38649823›Full record

ArticleBMC primary care2024

The relationship between relational continuity and family physician follow-up after an antidepressant prescription in older adults: a retrospective cohort study.

David Rudoler, Natasha Lane, Agnes Grudniewicz, Vicki Ling, David Snadden, Therese A Stukel

Abstract read
In one paragraph

Article in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David RudolerFaculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada. david.rudoler@ontariotechu.ca.ORCID 0000-0002-7564-5829
Natasha LaneDivision of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0003-1400-9068
Agnes GrudniewiczTelfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0003-2960-8178
Vicki LingICES Central, Toronto, Ontario, Canada.ORCID 0000-0001-5185-4709
David SnaddenUniversity of British Columbia Northern Medical Program, Prince George, British Columbia, Canada.
Therese A StukelICES Central, Toronto, Ontario, Canada.ORCID 0000-0001-9283-8764

Funding

CIHR FDN 143303
6 · The paper itself

Abstract

backgroundSide effects can occur within hours to days of starting antidepressant medications, whereas full therapeutic benefit for mood typically takes up to four weeks. This mismatch between time to harm and lag to benefit often leads to premature discontinuation of antidepressants, a phenomenon that can be partially reversed through early doctor-patient communication and follow-up. We investigated the relationship between relational continuity of care - the number of years family physicians have cared for older adult patients - and early follow-up care for patients prescribed antidepressants.

methodsA retrospective cohort study was conducted on residents of Ontario, Canada aged 66 years or older who were dispensed their first antidepressant prescription through the provincial drug insurance program between April 1, 2016, and March 31, 2019. The study utilized multivariable regression to estimate the relationship between relational continuity and 30-day follow-up with the prescribing family physician. Separate estimates were generated for older adults living in urban, non-major urban, and rural communities.

resultsThe study found a small positive relationship between relational continuity of care and follow-up care by the prescribing family physician for patients dispensed a first antidepressant prescription (RRR = 1.005; 95% CI = 1.004, 1.006). The relationship was moderated by the patients' location of dwelling, where the effect was stronger for older adults residing in non-major urban (RRR = 1.009; 95% CI = 1.007, 1.012) and rural communities (RRR = 1.006; 95% CI = 1.002, 1.011).

conclusionsOur findings do not provide strong evidence of a relationship between relational continuity of care and higher quality management of antidepressant prescriptions. However, the relationship is slightly more pronounced in rural communities where access to continuous primary care and specialized mental health services is more limited. This may support the ongoing need for the recruitment and retention of primary care providers in rural communities.

Indexed as

Antidepressive AgentsContinuity of Patient CareAgedAged, 80 and overFemaleHumansMaleOntarioPhysician-Patient RelationsPhysicians, FamilyRetrospective StudiesRural PopulationAntidepressive AgentsAdministrative health dataAntidepressantContinuity of careFamily medicineFollow-up carePrimary care

Identifiers

PMID38649823
PMCPMC11034035

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.