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Factors associated with antidepressant use among low-income racially and ethnically diverse patients with type 2 diabetes
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Factors associated with antidepressant use among low-income racially and ethnically diverse patients with type 2 diabetes
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Journal Article
Factors associated with antidepressant use among low-income racially and ethnically diverse patients with type 2 diabetes
2019
Overview
Depression is common in patients with type 2 diabetes and associated with poor diabetes-related outcomes. We evaluated the factors associated with antidepressant use in a low-income, racially and ethnically diverse sample of patients with type 2 diabetes.
We performed a cross-sectional study of baseline data from participants in a cluster randomized trial evaluating a health literacy intervention for diabetes care in safety net clinics. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D); antidepressant use was abstracted from medication lists. Multivariable mixed effects logistic regression was used to evaluate the relationship between antidepressant use and race/ethnicity adjusting for depressive symptoms, age, gender, income, and health literacy.
Of 403 participants, 58% were non-Hispanic White, 18% were non-Hispanic Black, and 24% were Hispanic. Median age was 51 years old; 60% were female, 52% of participants had a positive screen for depression, and 18% were on antidepressants. Black and Hispanic participants were significantly less likely to be on an antidepressant compared with white participants, adjusted odds ratios 0.31(95% CI: 0.12 to 0.80) and 0.26 (95% CI: 0.10 to 0.74), respectively.
In this vulnerable population with type 2 diabetes, we found a high prevalence of depressive symptoms, and a small proportion of participants were on an antidepressant. Black and Hispanic participants were significantly less likely to be treated with an antidepressant. Our findings suggest depression may be inadequately treated in low-income, uninsured patients with type 2 diabetes, especially racial and ethnic minorities.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Antidepressive Agents - therapeutic use
/ Continental Population Groups - statistics & numerical data
/ Diabetes
/ Diabetes Mellitus, Type 2 - complications
/ Diabetes Mellitus, Type 2 - psychology
/ Drug use
/ Ethnic Groups - statistics & numerical data
/ European Continental Ancestry Group
/ Female
/ Humans
/ Male
/ Medically Uninsured - statistics & numerical data
/ Minority Groups - statistics & numerical data
/ Population Groups - statistics & numerical data
