Real-world evidence from a European cohort study of patients with treatment resistant depression: Baseline patient characteristics.

Disease burden Health-related quality of life Major depressive disorder Observational study Patient-reported outcomes Socio-economic status

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 03 2021
Historique:
received: 01 10 2020
revised: 23 11 2020
accepted: 26 11 2020
pubmed: 6 2 2021
medline: 27 4 2021
entrez: 5 2 2021
Statut: ppublish

Résumé

Treatment resistant depression (TRD; failure to respond to ≥2 treatments) affects ~20% of patients with major depressive disorder (MDD). Real-world data could help describe patient characteristics and TRD disease burden, to assess the unmet needs of TRD patients in Europe. This observational study collected data from adults with moderate to severe TRD initiating a new treatment for depression, according to local standards of care. At baseline, socio-demographic characteristics, medical history, prior and current treatments were recorded. Disease severity, health-related quality of life (HRQoL), functionality and productivity were assessed. Overall, 411 eligible patients were enrolled across seven European countries. Mean (standard deviation [SD]) patient age was 51.0 (10.8) years; 62.3% were female. Long-term sick leave was reported by 19.0% of patients; 30.2% were unemployed. The mean (SD) duration of the current episode was 2.6 (3.9) years. At baseline, mean (SD) HRQoL scores for EuroQoL 5-dimension 5-level (UK tariff) and EQ-Visual Analog Scale were 0.41 (0.25) and 41.1 (18.7), respectively. The Work Productivity and Activity Impairment questionnaire demonstrated mean (SD) absenteeism of 57.0% (44.9%) and presenteeism of 54.7% (29.5%); mean (SD) overall work impairment was 60.5% (29.9%). Key limitations are small cohort size, absence of a control group and generalizability to countries with different healthcare models. TRD patients had a high disease burden, low HRQoL and reduced function and productivity, with a substantial proportion unable to work. This demonstrates an unmet treatment need in TRD patients that, if addressed, could reduce the heavy personal and societal burden.

Sections du résumé

BACKGROUND
Treatment resistant depression (TRD; failure to respond to ≥2 treatments) affects ~20% of patients with major depressive disorder (MDD). Real-world data could help describe patient characteristics and TRD disease burden, to assess the unmet needs of TRD patients in Europe.
METHODS
This observational study collected data from adults with moderate to severe TRD initiating a new treatment for depression, according to local standards of care. At baseline, socio-demographic characteristics, medical history, prior and current treatments were recorded. Disease severity, health-related quality of life (HRQoL), functionality and productivity were assessed.
RESULTS
Overall, 411 eligible patients were enrolled across seven European countries. Mean (standard deviation [SD]) patient age was 51.0 (10.8) years; 62.3% were female. Long-term sick leave was reported by 19.0% of patients; 30.2% were unemployed. The mean (SD) duration of the current episode was 2.6 (3.9) years. At baseline, mean (SD) HRQoL scores for EuroQoL 5-dimension 5-level (UK tariff) and EQ-Visual Analog Scale were 0.41 (0.25) and 41.1 (18.7), respectively. The Work Productivity and Activity Impairment questionnaire demonstrated mean (SD) absenteeism of 57.0% (44.9%) and presenteeism of 54.7% (29.5%); mean (SD) overall work impairment was 60.5% (29.9%).
LIMITATIONS
Key limitations are small cohort size, absence of a control group and generalizability to countries with different healthcare models.
CONCLUSIONS
TRD patients had a high disease burden, low HRQoL and reduced function and productivity, with a substantial proportion unable to work. This demonstrates an unmet treatment need in TRD patients that, if addressed, could reduce the heavy personal and societal burden.

Identifiants

pubmed: 33545659
pii: S0165-0327(20)33058-5
doi: 10.1016/j.jad.2020.11.124
pii:
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

115-122

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Auteurs

K Heerlein (K)

Janssen EMEA, Neuss, Germany. Electronic address: kheerlei@its.jnj.com.

A H Young (AH)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychological Medicine, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom.

C Otte (C)

Charité Universitätsmedizin, Berlin, Germany.

T Frodl (T)

Univeritätsklinikum Magdeburg, Otto von Guericke Universität Magdeburg, Magdeburg, Germany.

G Degraeve (G)

AZ Alma General Hospital, Eeklo, Belgium; PC Dr Guislain Hospital, Ghent, Belgium.

W Hagedoorn (W)

Practice for Psychiatry and Psychotherapy, Heerde, Netherlands.

A J Oliveira-Maia (AJ)

Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal; NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.

V Perez Sola (V)

Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona IMIM Hospital del Mar Medical Research Institute, Univ Autonoma de Barcelona, CIBERSAM, Department of Psychiatry, Barcelona, Spain.

S Rathod (S)

Southern Health NHS Foundation Trust, Research Department, Tom Rudd Unit, Southampton, United Kingdom.

G Rosso (G)

San Luigi Gonzaga Hospital, Department of Neurosciences, University of Turin, Turin, Italy.

P Sierra (P)

University and Polytechnic Hospital La Fe, Valencia, University of Valencia, Spain.

J Morrens (J)

Janssen EMEA, Beerse, Belgium.

G Van Dooren (G)

Janssen EMEA, Beerse, Belgium.

Y Gali (Y)

Janssen EMEA, Beerse, Belgium.

G Perugi (G)

University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy.

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Classifications MeSH