Madison Brotze and Mark LaBossiere
James H. Quillen VA Medical Center – Mountain Home, TN
Contact Information:
[email protected]Background/Purpose: Depression is common among Veterans, and many do not respond to multiple antidepressant trials, resulting in treatment-resistant depression (TRD). TRD contributes to increased symptom burden, higher healthcare use, and more complex care needs. Vilazodone and vortioxetine are two antidepressants that may offer advantages for Veterans with TRD due to their unique mechanisms and potentially better tolerability profiles. This quality improvement project aims to assess current prescribing of these agents, in addition to evaluating rates of discontinuation, adherence, tolerability, and healthcare utilization associated to identify potential opportunities to improve treatment selection and care processes for Veterans with TRD.
Methodology: This project will identify Veterans initiated on vilazodone or vortioxetine at the James H. Quillen VAMC. Time to discontinuation will be evaluated from the date of medication initiation through 3, 6, and 12 months. Medication adherence will be assessed using the medication possession ratio (MPR), and reasons for discontinuation will be collected from the electronic health record. Healthcare utilization measures, including psychiatric hospitalizations and activation of high-risk suicide flags during treatment, will also be reviewed. Data will be compared between vilazodone and vortioxetine to identify trends, gaps, and opportunities to improve antidepressant management for Veterans with TRD.
Results: In progress
Conclusion: In progress
