Real-world evidence from a European cohort study of patients with treatment resistant depression: Healthcare resource utilization
Heerlein K. De Giorgi S. Degraeve G. Frodl T. Hagedoorn W. Oliveira-Maia A.J. Otte C. Perez Sola V. Rathod S. Rosso G. Sierra P. Vita A. Morrens J. Rive B. Mulhern Haughey S. Kambarov Y. Young A.H.
1 February 2022Elsevier B.V.
Journal of Affective Disorders
2022#298442 - 450 pp.
Background: Treatment resistant depression (TRD) is diagnosed when patients experiencing a major depressive episode fail to respond to ≥2 treatments. Along with substantial indirect costs, patients with TRD have higher healthcare resource utilization (HCRU) than other patients with depression. However, research on the economic impact of this HCRU, and differences according to response to treatment, is lacking. Methods: This multicenter, observational study documented HCRU among patients with TRD in European clinical practice initiating new antidepressant treatments. Data regarding access to outpatient consultations and other healthcare resources for the first 6 months, collected using a questionnaire, were analyzed qualitatively according to response and remission status. The economic impact of HCRU, estimated using European costing data, was analyzed quantitatively. Results: Among 411 patients, average HCRU was higher in non-responders, attending five times more general practitioner (GP) consultations and spending longer in hospital (1.7 versus 1.1 days) than responders. Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Consequently, the estimated economic impacts of non-responders and non-remitters were significantly greater than those of responders and remitters, respectively. Limitations: Key limitations are small cohort size, absence of control groups and generalizability to different healthcare systems. Conclusion: Patients with TRD, particularly those not achieving remission, have considerable HCRU, with associated economic impact. The costs of unmet TRD treatment needs are thus substantial, and treatment success is fundamental to reduce individual needs and societal costs.
Healthcare resource utilization , Major depressive disorder , Observational study , Real-world evidence , Treatment resistant depression
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Janssen EMEA, Neuss, Germany
Department of Mental Health ASL Lecce, Lecce, Italy
AZ Alma General Hospital, Eeklo, Belgium
PC Dr Guislain Hospital, Ghent, Belgium
Department of Psychiatry and Psychotherapy, Univeritätsklinikum Magdeburg, Otto von Guericke Universität Magdeburg, Magdeburg, Germany
Practice for Psychiatry and Psychotherapy, Heerde, Netherlands
Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
Charité Universitätsmedizin, Berlin, Germany
Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona IMIM Hospital del Mar Medical Research Institute, Univ Autonoma de Barcelona, CIBERSAM, Barcelona, Spain
Research Department, Southern Health NHS Foundation Trust, Tom Rudd Unit, Southampton, United Kingdom
Department of Neurosciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
University and Polytechnic Hospital La Fe, University of Valencia, Valencia, Spain
Department of Mental Health and Addiction Services, Spedali Civili Hospital and University of Brescia, Brescia, Italy
Janssen EMEA, Beerse, Belgium
Janssen EMEA, Paris, France
Janssen EMEA, Dublin, Ireland
Janssen EMEA, Almaty, Kazakhstan
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
Janssen EMEA
Department of Mental Health ASL Lecce
AZ Alma General Hospital
PC Dr Guislain Hospital
Department of Psychiatry and Psychotherapy
Practice for Psychiatry and Psychotherapy
Champalimaud Research and Clinical Centre
NOVA Medical School
Charité Universitätsmedizin
Department of Psychiatry
Research Department
Department of Neurosciences
University and Polytechnic Hospital La Fe
Department of Mental Health and Addiction Services
Janssen EMEA
Janssen EMEA
Janssen EMEA
Janssen EMEA
Department of Psychological Medicine
South London and Maudsley NHS Foundation Trust
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