OBJECTIVES: Among individuals currently treated for depression, there may be inequalities in health outcomes, attitudes, and overall care between those who have previously taken depression medication and those on their first medication. This study aimed to examine differences between individuals with prior treatment (PT) versus those with no prior treatment (NPT) for depression in 1) class of medication taken, 2) healthcare resource use (HRU), 3) patient activation, 4) treatment satisfaction, 5) severity of depression, 6) adherence, and 7) health related quality of life.

METHODS: : Data from the NHWS 2021 included respondents at least 18 years of age who reported a diagnosis and current monotherapy for depression, resided in the United States, and were not diagnosed with bipolar disorder or schizophrenia. T-tests and Chi-square tests were used to compare quantitative and qualitative data, respectively, between the two groups.

RESULTS: : A total of 4255 eligible respondents self-reported a physician diagnosis of depression (PT: n=1810, NPT: n=2445) and were predominantly white (83.2%) and female (74.4%). Selective serotonin reuptake inhibitors (SSRIs) were the most common current treatment in both groups (PT: 51.6%, NPT: 62.0%). PT respondents reported greater HRU (p<0.01). More PT respondents were at Level 1 of the Patient Activation Measure (PAM) (disengaged/overwhelmed; 9.2% vs 6.9%, p<0.01). Both groups reported high overall treatment satisfaction (5.2 out of 7). Mean PHQ-9 scores for both groups fell in “mild-moderate.” PHQ-9 scores conveyed a more severe depression level in the PT group (p<0.001). Both groups reported high medication adherence (overall mean=87.42%). The average mental component score was notably low regardless of group (overall mean=38.69).

CONCLUSIONS: : A history of prior medication treatment was associated with greater HRU, lower activation, and more severe depression. Increased attention by healthcare providers and further investigation may be warranted in this population to better address patients’ personal health needs.