Key result
Comorbid depression in rheumatoid arthritis patients was associated with increased healthcare utilization and an incremental adjusted annual all-cause direct cost of $8,488 (95% CI $6,793-$10,223).
Why the study?
Comorbid depression is the most frequent comorbidity in rheumatoid arthritis and worsens clinical outcomes, but its impact on healthcare utilization, expenditures, and work productivity required assessment.
Does comorbid depression increase healthcare utilization, work productivity loss, and economic burden in adults with rheumatoid arthritis?
Observational (n=46,700)
Does comorbid depression increase healthcare utilization, work productivity loss, and economic burden in adults with rheumatoid arthritis?
Mean Difference: 8488 (95% CI 6793–10223)
Comorbid depression in patients with rheumatoid arthritis is associated with significantly increased healthcare utilization, work productivity loss, and economic burden.
RA patients with comorbid depression incur higher utilization and costs; hypothesis-generating for integrated management pending prospective trials.
AIMS: Depression is the most frequent comorbidity reported among patients with rheumatoid arthritis (RA). Comorbid depression negatively impacts RA patients' health-related quality-of-life, physical function, mental function, mortality, and experience of pain and symptom severity. The objective of this study was to assess healthcare utilization, expenditures, and work productivity among patients with RA with or without depression. MATERIALS AND METHODS: Data from adult patients who had at least two visits each related to RA and depression over a 1-year period were extracted from the Truven Health MarketScan research databases. Outcomes comprised healthcare resource utilization, work productivity loss, and direct healthcare costs comparing patients with RA with depression (n = 3,478) vs patients with RA without depression (n = 43,222). RESULTS: Patients with RA and depression had a significantly greater relative risk of hospitalization and number of all-cause and RA-related hospitalizations, utilization of emergency services, days spent in the hospital, physician visits, and RA-related surgeries compared with RA patients without depression. Patients with RA and depression had a higher risk of and experienced more events and days of short-term disability compared with patients without depression. The incremental adjusted annual all-cause and RA-related direct costs were $8,488 (95% CI = $6,793-$10,223) and $578 (95% CI = -$98-$1,243), respectively, when comparing patients with RA and depression vs RA only. LIMITATIONS: The current analysis is subject to the known limitations of retrospective studies based on administrative claims data. CONCLUSIONS: This study suggested increased healthcare utilization, work productivity loss, and economic burden among RA patients due to comorbid depression. These findings emphasize the importance of managing depression and including depression as a factor when devising treatment algorithms for patients with RA.
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Li et al. (2019) conducted an observational in Rheumatoid arthritis (n=46,700). Comorbid depression vs. No depression was evaluated on Incremental adjusted annual all-cause direct costs (MD $8,488, 95% CI $6,793-$10,223). Comorbid depression in rheumatoid arthritis patients was associated with increased healthcare utilization and an incremental adjusted annual all-cause direct cost of $8,488 (95% CI $6,793-$10,223).
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