Economic impact of treatment-resistant depression: A retrospective observational study
| Autor: | Andrea Gabilondo, Aram Sicras-Navarro, Víctor Pérez-Sola, Eduard Vieta, Berta Herrera, Teresa Hernando, Jordi Alonso, Antoni Sicras-Mainar, Miquel Roca |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Population Economic burden Major depressive disorder Indirect costs Depressive Disorder Treatment-Resistant Internal medicine Medicine Humans Cumulative incidence education Depression (differential diagnoses) Retrospective Studies education.field_of_study Depressive Disorder Major business.industry Depression Incidence Incidence (epidemiology) Retrospective cohort study Health Care Costs Middle Aged medicine.disease Psychiatry and Mental health Clinical Psychology Female Treatment-resistant depression business |
| Zdroj: | Journal of affective disorders. 295 |
| ISSN: | 1573-2517 |
| Popis: | Background: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. Methods: A retrospective, observational-study was carried out using data from the BIG-PAC database®. Patients aged ≥18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with ≥2 antidepressants including the prescription of ≥3 antidepressants (N06A) or ≥2 antidepressant and ≥1 antipsychotic (N05A; including lithium) b) antidepressants administered for ≥ 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was ≤ 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. Outcomes: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). Results: 21,630 patients with MDD aged ≥ 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 person-years, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were €4,147.9, being higher for TRD than for non-TRD patients (€6,096 vs. €3,846; p |
| Databáze: | OpenAIRE |
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