KEY TAKEAWAYS
- The study aimed to analyze AD/AA medication patterns before and after benign hysterectomy and identify distinct usage clusters.
- Researchers noted that GBTM revealed 6 distinct AD/AA medication trajectories, indicating opportunities for targeted interventions.
This study investigates the dispensing patterns of antidepressant (AD) and antianxiety (AA) medications among women with psychiatric disorders undergoing benign hysterectomy for endometriosis and uterine fibroids. By employing group-based trajectory modeling (GBTM), the study tracks changes in medication usage over time, both before and after the hysterectomy.
The analysis aims to reveal how medication patterns shift in response to improvements in gynecologic symptoms or the emotional impact of the procedure. Identifying these patterns helps in understanding the relationship between gynecologic interventions and psychiatric medication use, providing insight into patient behaviors and treatment needs.
Ryota Ishiwata and the team aimed to assess the distinct trajectories of AD/AA medication dispensing and characterize patient clusters based on these patterns to inform targeted interventions.
They performed an inclusive analysis using data from the Merative MarketScan® Research Databases (Ann Arbor, MI, USA) to study women who underwent a benign hysterectomy. Inclusion criteria encompassed reproductive-aged women (18-50 years) with at least 1 mood or anxiety disorder diagnosis and at least 1 dispensing of AD or AA medications.
The study measured monthly adherence and persistence of AD/AA medication use over 12 months following the hysterectomy. GBTM was employed to identify distinct trajectory groups of monthly AD/AA medication dispensing. Additionally, multinomial logistic regression was utilized to determine factors independently associated with the identified dispensing trajectory patterns.
About 11,607 patients were analyzed, revealing 6 dispensing trajectory groups during the study period: continuously high (27.0%), continuously moderate (21.9%), continuously low (17.9%), low-to-high (10.0%), moderate-to-low (9.8%), and low-to-moderate (13.4%).
Compared with the continuously high group, younger age, no history of a mood disorder, and uterine fibroids were identified as clinical predictors of low dispensing. The discontinuation rate at 3 months after hysterectomy was notably higher at 88.6% in the continuously low group and 66.5% in the continuously low-to-moderate group.
The study concluded that GBTM identified six distinct trajectories of AD and AA medication dispensing in the perioperative period. These trajectory models could be utilized to pinpoint specific dispensing patterns, allowing for targeted interventions to address the varying medication use behaviors observed among patients.
This study was funded by the NIH grant R01HD094380 to Mostafa A Borahay.
Source: https://pubmed.ncbi.nlm.nih.gov/39165003/
Ishiwata R, AlAshqar A, Miyashita-Ishiwata M, et al. (2024). “Dispensing patterns of antidepressant and antianxiety medications for psychiatric disorders after benign hysterectomy in reproductive-age women: Results from group-based trajectory modeling.” Womens Health (Lond). 2024;20:17455057241272218. doi:10.1177/17455057241272218
