This finding is consistent with evidence in the general population that antidepressant prescribing is often not followed by ongoing care needed for guideline consistent antidepressant treatment (often leading to changes in dosing, choice of medication, or augmentation) (Chen, Hansen, Farley et al., 2010; Chen, Hansen, Gaynes et al., 2010). This trend may be especially problematic in older and sicker patients where physicians may appropriately ‘start low, go slow’ but then lack of follow-up may leave patients on sub-therapeutic doses of antidepressants (Mojtabai & Olfson, 2008; Wright et al., 2009).