Measuring Response to Adjunctive Therapy Among Individuals with Major Depressive Disorder.
PHQ-9
adjunctive therapy
major depressive disorder
measurement-based care
psychotherapy
Journal
Neuropsychiatric disease and treatment
ISSN: 1176-6328
Titre abrégé: Neuropsychiatr Dis Treat
Pays: New Zealand
ID NLM: 101240304
Informations de publication
Date de publication:
2022
2022
Historique:
received:
14
05
2022
accepted:
17
09
2022
entrez:
4
11
2022
pubmed:
5
11
2022
medline:
5
11
2022
Statut:
epublish
Résumé
Incomplete or inadequate response to first-line antidepressant therapy (ADT) for major depressive disorder (MDD) is common. Response to adjunctive therapy is less understood. To estimate response to adjunctive pharmacotherapy or psychotherapy among individuals with MDD on an antidepressant using the PHQ-9 questionnaire. This was a retrospective cohort analysis using medical and pharmacy insurance claims among individuals with MDD or ADT who initiated adjunctive pharmacotherapy, psychotherapy, or both (dual). Eligible individuals initiated adjunctive therapy between 7/1/2014-12/31/2018. Symptom severity was measured by PHQ-9 score in the 6-month baseline and 12-month follow up. Multivariate logistic regression identified factors associated with improved symptom severity. Most (81.8%) of the 2389 participants initiated adjunctive pharmacotherapy, followed by psychotherapy (12.7%) and dual adjunctive (5.5%). Only 30.2% had both a baseline and follow-up PHQ-9 score. Among those with mild or more severe PHQ-9 baseline scores, 36.7% had the same or worse MDD severity during follow-up. Among those with moderate or more severe baseline scores, 28.1% had the same or worse MDD severity during follow-up. Most individuals with moderate-to-severe MDD did not receive a follow-up questionnaire, suggesting incomplete monitoring of treatment response. Among those with a PHQ-9 following initiation of adjunctive therapy, many continued to report impactful symptoms. Future studies should explore alternate treatment approaches and methods to support the utilization of the PHQ-9 for monitoring treatment response.
Sections du résumé
Background
UNASSIGNED
Incomplete or inadequate response to first-line antidepressant therapy (ADT) for major depressive disorder (MDD) is common. Response to adjunctive therapy is less understood.
Objective
UNASSIGNED
To estimate response to adjunctive pharmacotherapy or psychotherapy among individuals with MDD on an antidepressant using the PHQ-9 questionnaire.
Methods
UNASSIGNED
This was a retrospective cohort analysis using medical and pharmacy insurance claims among individuals with MDD or ADT who initiated adjunctive pharmacotherapy, psychotherapy, or both (dual). Eligible individuals initiated adjunctive therapy between 7/1/2014-12/31/2018. Symptom severity was measured by PHQ-9 score in the 6-month baseline and 12-month follow up. Multivariate logistic regression identified factors associated with improved symptom severity.
Results
UNASSIGNED
Most (81.8%) of the 2389 participants initiated adjunctive pharmacotherapy, followed by psychotherapy (12.7%) and dual adjunctive (5.5%). Only 30.2% had both a baseline and follow-up PHQ-9 score. Among those with mild or more severe PHQ-9 baseline scores, 36.7% had the same or worse MDD severity during follow-up. Among those with moderate or more severe baseline scores, 28.1% had the same or worse MDD severity during follow-up.
Conclusion
UNASSIGNED
Most individuals with moderate-to-severe MDD did not receive a follow-up questionnaire, suggesting incomplete monitoring of treatment response. Among those with a PHQ-9 following initiation of adjunctive therapy, many continued to report impactful symptoms. Future studies should explore alternate treatment approaches and methods to support the utilization of the PHQ-9 for monitoring treatment response.
Identifiants
pubmed: 36330373
doi: 10.2147/NDT.S369450
pii: 369450
pmc: PMC9624149
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2467-2475Informations de copyright
© 2022 Forma et al.
Déclaration de conflit d'intérêts
Ms Felicia Forma is an employee of Otsuka Pharmaceuticals Development & Commercialization, Inc., during the conduct of the study. Dr Joshua N Liberman, Ms Pinyao Rui, Ms Emily Wiggins, Dr Charles Ruetsch are employees of Health Analytics, LLC. Dr Charles Ruetsch reports personal fees from Otsuka America, during the conduct of the study; personal fees from Otsuka America, Janssen, and Orexo, outside the submitted work. The authors report no other conflicts of interest in this work.
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