Jennifer Voelker1, Kun Wang2, Wenze Tang2, Jinghua He2, Ella Daly3, Christopher D Pericone2, John J Sheehan2. 1. Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA. JVoelke4@its.jnj.com. 2. Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA. 3. Janssen Research & Development, LLC, 1125 Trenton Harbourton Rd, Titusville, NJ, 08560, USA.
Abstract
BACKGROUND: Despite the availability of pharmacologic and nonpharmacologic treatment options, depression continues to be one of the leading causes of disability worldwide. This study evaluated whether depression symptom severity, as measured by PHQ-9 score, of patients diagnosed with MDD is associated with short-term risk of a hospital encounter (ER visit or inpatient stay). METHODS: Adults with ≥1 PHQ-9 assessment in an outpatient setting (index date) and ≥ 1 MDD diagnosis within 6 months prior were included from the de-identified Optum Electronic Health Record database (April 2016-June 2019). Patients were categorized by depression symptom severity based on PHQ-9 scores obtained by natural language processing. Crude rates, adjusted absolute risks, and adjusted relative risks of all-cause and MDD-related hospital encounters within 30 days following assessment of depression severity were determined. RESULTS: The study population consisted of 280,145 patients with MDD and ≥ 1 PHQ-9 assessment in an outpatient setting. Based on PHQ-9 scores, 26.9% of patients were categorized as having none/minimal depression symptom severity, 16.4% as mild, 24.7% as moderate, 19.6% as moderately severe, and 12.5% as severe. Among patients with none/minimal, mild, moderate, moderately severe, and severe depression, the adjusted absolute short-term risks of an initial all-cause hospital encounter were 4.1, 4.4, 4.8, 5.6, and 6.5%, respectively; MDD-related hospital encounter adjusted absolute risks were 0.8, 1.0, 1.3, 1.6, and 2.1%, respectively. Compared to patients with none/minimal depression symptom severity, the adjusted relative risks of an all-cause hospital encounter were 1.60 (95% CI 1.50-1.70) for those with severe, 1.36 (1.29-1.44) for those with moderately severe, 1.18 (1.12-1.25) for those with moderate, and 1.07 (1.00-1.13) for those with mild depression symptom severity. CONCLUSIONS: These study findings indicate that depression symptom severity is a key driver of short-term risk of hospital encounters, emphasizing the need for timely interventions that can ameliorate depression symptom severity.
BACKGROUND: Despite the availability of pharmacologic and nonpharmacologic treatment options, depression continues to be one of the leading causes of disability worldwide. This study evaluated whether depression symptom severity, as measured by PHQ-9 score, of patients diagnosed with MDD is associated with short-term risk of a hospital encounter (ER visit or inpatient stay). METHODS: Adults with ≥1 PHQ-9 assessment in an outpatient setting (index date) and ≥ 1 MDD diagnosis within 6 months prior were included from the de-identified Optum Electronic Health Record database (April 2016-June 2019). Patients were categorized by depression symptom severity based on PHQ-9 scores obtained by natural language processing. Crude rates, adjusted absolute risks, and adjusted relative risks of all-cause and MDD-related hospital encounters within 30 days following assessment of depression severity were determined. RESULTS: The study population consisted of 280,145 patients with MDD and ≥ 1 PHQ-9 assessment in an outpatient setting. Based on PHQ-9 scores, 26.9% of patients were categorized as having none/minimal depression symptom severity, 16.4% as mild, 24.7% as moderate, 19.6% as moderately severe, and 12.5% as severe. Among patients with none/minimal, mild, moderate, moderately severe, and severe depression, the adjusted absolute short-term risks of an initial all-cause hospital encounter were 4.1, 4.4, 4.8, 5.6, and 6.5%, respectively; MDD-related hospital encounter adjusted absolute risks were 0.8, 1.0, 1.3, 1.6, and 2.1%, respectively. Compared to patients with none/minimal depression symptom severity, the adjusted relative risks of an all-cause hospital encounter were 1.60 (95% CI 1.50-1.70) for those with severe, 1.36 (1.29-1.44) for those with moderately severe, 1.18 (1.12-1.25) for those with moderate, and 1.07 (1.00-1.13) for those with mild depression symptom severity. CONCLUSIONS: These study findings indicate that depression symptom severity is a key driver of short-term risk of hospital encounters, emphasizing the need for timely interventions that can ameliorate depression symptom severity.
Entities:
Keywords:
Depression symptom severity; Healthcare resource utilization; Hospital encounter; Major depressive disorder; Natural language processing; PHQ-9 assessment
Authors: K Mikael Holma; Tarja K Melartin; Jari Haukka; Irina A K Holma; T Petteri Sokero; Erkki T Isometsä Journal: Am J Psychiatry Date: 2010-05-17 Impact factor: 18.112
Authors: Sarah Ballou; Shuji Mitsuhashi; Lindsey S Sankin; Travis S Petersen; Julia Zubiago; Cara Lembo; Eve Takazawa; Jesse Katon; Thomas Sommers; William Hirsch; Vikram Rangan; Mike Jones Journal: Gen Hosp Psychiatry Date: 2019-04-24 Impact factor: 3.238
Authors: Didi Rhebergen; Aartjan T F Beekman; Ron de Graaf; Willem A Nolen; Jan Spijker; Witte J Hoogendijk; Brenda W J H Penninx Journal: J Affect Disord Date: 2009-11-28 Impact factor: 4.839
Authors: Deborah S Hasin; Aaron L Sarvet; Jacquelyn L Meyers; Tulshi D Saha; W June Ruan; Malka Stohl; Bridget F Grant Journal: JAMA Psychiatry Date: 2018-04-01 Impact factor: 21.596
Authors: Albert L Siu; Kirsten Bibbins-Domingo; David C Grossman; Linda Ciofu Baumann; Karina W Davidson; Mark Ebell; Francisco A R García; Matthew Gillman; Jessica Herzstein; Alex R Kemper; Alex H Krist; Ann E Kurth; Douglas K Owens; William R Phillips; Maureen G Phipps; Michael P Pignone Journal: JAMA Date: 2016-01-26 Impact factor: 56.272
Authors: Hillary Samples; Elizabeth A Stuart; Brendan Saloner; Colleen L Barry; Ramin Mojtabai Journal: J Gen Intern Med Date: 2019-08-06 Impact factor: 5.128
Authors: Maurizio Pompili; Marco Innamorati; Denise Erbuto; Mario Luciano; Gaia Sampogna; Giovanni Abbate-Daga; Stefano Barlati; Claudia Carmassi; Giovanni Castellini; Pasquale De Fazio; Giorgio Di Lorenzo; Marco Di Nicola; Silvia Ferrari; Arianna Goracci; Carla Gramaglia; Giovanni Martinotti; Maria Giulia Nanni; Massimo Pasquini; Federica Pinna; Nicola Poloni; Gianluca Serafini; Maria Signorelli; Alfonso Tortorella; Antonio Ventriglio; Umberto Volpe; Andrea Fiorillo Journal: Eur Psychiatry Date: 2022-08-31 Impact factor: 7.156