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Health care utilisation in treatment-resistant depression: a Swedish population-based cohort study.

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Title: Health care utilisation in treatment-resistant depression: a Swedish population-based cohort study.
Authors: Brenner, Philip, Nygren, Adam, Hägg, David, Tiger, Mikael, O'Hara, Marguerite, Brandt, Lena, Reutfors, Johan
Source: International Journal of Psychiatry in Clinical Practice. Sep2022, Vol. 26 Issue 3, p251-258. 8p.
Subjects: Mental depression, Psychotherapy patients, Confidence intervals, Medical care, Medical care use, Psychosocial factors, Descriptive statistics, Longitudinal method
Geographic Terms: Sweden
Abstract: To investigate the health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to patients with depression not meeting TRD criteria. Nationwide Swedish registers were used to identify patients 18–69 years old with incident depression and antidepressant treatment. Patients were followed prospectively and defined as having TRD at start of the third distinct consecutive treatment episode. Each of the 16,329 identified TRD patients were matched with five comparators with depression not meeting criteria for TRD. Main outcome measure was total number of inpatient days and outpatient visits, and secondary outcome was HCU in connection with a main diagnosis of depression or suicide attempt. TRD patients had a significantly higher risk of all-cause inpatient care than comparators (first year adjusted risk ratio [aRR] 3.03 [95%CI 3.01–3.05], years 1–3 aRR 2.15 [2.13–2.16]). This was more pronounced when the main diagnosis was depression (first year aRR 4.41 [4.36–4.45]), and after suicide attempt (first year aRR 4.43 [4.26–4.60]). Outpatient visits were also markedly more frequent for patients with TRD (first year aRR 2.05 [2.03–2.07]). Higher HCU among TRD patients persisted throughout follow-up. Patients with TRD may have a twofold to fourfold higher HCU than other patients with depression. This register-based prospective study investigated health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to other patients with depression. Patients with TRD had a two to fourfold higher HCU regarding all measured outcomes, including inpatient hospital days and outpatient visits. The elevated HCU persisted for more than three years, although decreasing gradually. This should correspond to increased costs and individual burden for patients with TRD. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Health care utilisation in treatment-resistant depression: a Swedish population-based cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Brenner%2C+Philip%22">Brenner, Philip</searchLink><br /><searchLink fieldCode="AR" term="%22Nygren%2C+Adam%22">Nygren, Adam</searchLink><br /><searchLink fieldCode="AR" term="%22Hägg%2C+David%22">Hägg, David</searchLink><br /><searchLink fieldCode="AR" term="%22Tiger%2C+Mikael%22">Tiger, Mikael</searchLink><br /><searchLink fieldCode="AR" term="%22O'Hara%2C+Marguerite%22">O'Hara, Marguerite</searchLink><br /><searchLink fieldCode="AR" term="%22Brandt%2C+Lena%22">Brandt, Lena</searchLink><br /><searchLink fieldCode="AR" term="%22Reutfors%2C+Johan%22">Reutfors, Johan</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Psychiatry+in+Clinical+Practice%22">International Journal of Psychiatry in Clinical Practice</searchLink>. Sep2022, Vol. 26 Issue 3, p251-258. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy+patients%22">Psychotherapy patients</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+use%22">Medical care use</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Sweden%22">Sweden</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: To investigate the health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to patients with depression not meeting TRD criteria. Nationwide Swedish registers were used to identify patients 18–69 years old with incident depression and antidepressant treatment. Patients were followed prospectively and defined as having TRD at start of the third distinct consecutive treatment episode. Each of the 16,329 identified TRD patients were matched with five comparators with depression not meeting criteria for TRD. Main outcome measure was total number of inpatient days and outpatient visits, and secondary outcome was HCU in connection with a main diagnosis of depression or suicide attempt. TRD patients had a significantly higher risk of all-cause inpatient care than comparators (first year adjusted risk ratio [aRR] 3.03 [95%CI 3.01–3.05], years 1–3 aRR 2.15 [2.13–2.16]). This was more pronounced when the main diagnosis was depression (first year aRR 4.41 [4.36–4.45]), and after suicide attempt (first year aRR 4.43 [4.26–4.60]). Outpatient visits were also markedly more frequent for patients with TRD (first year aRR 2.05 [2.03–2.07]). Higher HCU among TRD patients persisted throughout follow-up. Patients with TRD may have a twofold to fourfold higher HCU than other patients with depression. This register-based prospective study investigated health care utilisation (HCU) among patients with treatment-resistant depression (TRD) compared to other patients with depression. Patients with TRD had a two to fourfold higher HCU regarding all measured outcomes, including inpatient hospital days and outpatient visits. The elevated HCU persisted for more than three years, although decreasing gradually. This should correspond to increased costs and individual burden for patients with TRD. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/13651501.2021.2003405
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 8
        StartPage: 251
    Subjects:
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Psychotherapy patients
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Medical care
        Type: general
      – SubjectFull: Medical care use
        Type: general
      – SubjectFull: Psychosocial factors
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Sweden
        Type: general
    Titles:
      – TitleFull: Health care utilisation in treatment-resistant depression: a Swedish population-based cohort study.
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            – D: 01
              M: 09
              Text: Sep2022
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              Y: 2022
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