一项针对 11 万名患者的纵向人群队列研究显示,重度抑郁症和耐药性抑郁症患者的医疗利用率和相关经济负担。

IF 3.7 2区 医学 Q1 PSYCHIATRY
Sofia Pappa , Moulesh Shah , Sophie Young , Tazneem Anwar , Timothy Ming
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引用次数: 0

摘要

重度抑郁障碍(MDD),尤其是治疗耐受性抑郁(TRD),导致高水平的医疗使用和疾病负担。本研究旨在评估和比较这些患者群体的医疗资源使用情况和相关成本。该平台是欧洲最大的互联数据集之一,由帝国理工学院健康合作伙伴托管,其中包含编码的急诊和常规、初级和中级、身体和精神健康数据,覆盖人口超过 250 万。符合条件的患者是在 2015 年至 2020 年期间诊断出患有 MDD 并至少服用过一种抗抑郁药的成年人。共纳入 110406 名患者,其中 101333 人[92%]患有 MDD,9073 人[8%]患有 TRD。MDD患者的平均抑郁持续时间为52.8个月(标准差为41.7个月),TRD患者的平均抑郁持续时间为70.8个月(标准差为37.8个月)(p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health-care utilisation and associated economic burden in major depressive disorder and treatment-resistant depression in a longitudinal population-based cohort study of 110.000 patients
Major depressive disorder (MDD), and particularly treatment-resistant depression (TRD), lead to high levels of health-care use and disease burden. The aim of this study was to evaluate and compare the health-care resource utilisation and associated costs in these patient groups. It was a population-wide, retrospective analysis of NHS health-care electronic records in northwest London using the Discover-NOW platform, one of the largest interlinked datasets in Europe hosted by Imperial College Health Partners, which contains coded emergency and routine, primary and secondary, physical and mental health data, covering a population of more than 2.5 million. Eligible patients were adults with a diagnosis of MDD who had been prescribed at least one antidepressant between 2015 and 2020. A total of 110,406 patients were included, 101,333 [92%] with MDD and 9073 [8%] with TRD. Mean duration of depression was 52.8 (SD 41.7) months for MDD and 70.8 (SD 37.8) months for TRD (p < 0.0001). Patients with TRD had significantly higher risks of both psychiatric and somatic comorbidities such as anxiety, asthma, and alcohol misuse (all p < 0.0001). They also demonstrated increased primary care and emergency attendance rates, more frequent and longer hospitalizations, and on average 1.5 times greater total healthcare costs compared to MDD patients. Primary care visits represented the largest proportion overall (TRD mean 162 [SD 96] vs. MDD 108 [90] visits per patient, p < 0.0001; cost per patient £17,348 [SD £33,040] vs. £12,011 [£25,588], p < 0.0001) during the study period. In secondary care, accident and emergency visits accounted for the highest use (TRD mean 5.5 [10.6] vs. MDD 3.54 [SD 6.0] visits per patient, p < 0.0001) while non-elective hospitalisations incurred the highest costs (mean £2518 [£8064] vs. £1909 [SD £6807], p < 0.0001). Demand increased with the duration of depression and the number of lines of treatment. The study highlights the substantial clinical and economic burden associated with MDD and especially TRD across different care settings.
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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