Evaluation of antidepressant treatment in patient with comorbidity. Using informatics technology

OBJECTIVE: To evaluate the quality of care and improvement opportunities of medically ill depressed patients in a Psychiatric Facility using electronic medical records. METHODS: Observational, retrospective study. A literature review was conducted to identify and analyze evidence based quality indicators. We scored the clinical records to estimate the proportion of continuous antidepressant treatment at 12 and 24 weeks, response and remission rates at 8 weeks, the use of clinimetric scales, evidence based psychotherapeutic interventions (cognitive and interpersonal), and the emergence of antidepressant related safety events. RESULTS: Of 100 patients with an average age of 48.7 years, 49 % and 34 % received treatment during 12 and 24 weeks respectively. 50 % had response and 28 % remission at 8 weeks. Use of clinimetric scales was registered in 33 % and psychotherapeutic interventions in 28 % of the interviews. One patient had seizures related to antidepressant use. CONCLUSIONS: An increase in the proportion of patients achieving remission and the use of clinimetric scales with psychotherapeutic interventions are improvement opportunities to look for in the care of depressed patients with medical comorbidity.