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Impact of Moderate-to-High-Suicide-Intent in Major Depressive Disorder: Patient Characteristics and Healthcare Resource Utilisation in England
15 Pages Posted: 4 Aug 2022
More...Abstract
Background: We aimed to characterise patients with major depressive disorder (MDD) with moderate-to-high-suicide-intent in England, compare their healthcare resource utilisation (HCRU) to patients with MDD without moderate-to-high-suicide-intent, and better understand their patient pathways.
Methods: This retrospective cohort study used data collected from primary care electronic health records from Clinical Practice Research Datalink (CPRD), linked to Hospital Episode Statistics (HES), Mental Health Services Data Set (MHSDS), and Office for National Statistics (ONS) in England. Adults diagnosed with at least one MDD diagnosis between 04/2007-11/2015 were categorised by suicide intent.
Outcomes: 307,476 patients with MDD were included (294,259 patients without moderate-to-high-suicide-intent and 13,217 patients with moderate-to-high-suicide-intent). Patients with MDD with moderate-to-high-suicide-intent were younger on average and included more males than females compared to patients without moderate-to-high-suicide-intent (age: 39·0 vs. 44·8 years; female: 58% vs. 65%). HCRU was greater among patients with moderate-to-high-suicide-intent than patients without moderate-to-high-suicide-intent during the first follow-up year for the following: general practitioner consultations (38·5 vs. 29·4), psychiatric outpatient visits (1·5 vs. 0·1), psychiatrist visits (3·6 vs. 0·3), accident and emergency visits (1·5 vs. 0·3), and hospitalisations (86% vs. 26%). Overall, 56% of patients with moderate-to-high-suicide-intent had an antidepressant prescription within 30 days of the initial moderate-to-high-suicide-intent.
Interpretation: Patients with MDD and moderate-to-high-suicide-intent were younger, included more males than females and incurred greater HCRU than those without moderate-to-high-suicide-intent. These results demonstrate the greater need for effective treatment and medical care among patients with moderate-to-high-suicide-intent, which could help reduce associated symptoms, mortality due to suicide, and HCRU.
Funding Information: This study was funded by Janssen-Cilag Ltd.
Declaration of Interests: • TD, CK, and SR are employees of Janssen, pharmaceutical company of Johnson & Johnson and hold stock options; • ND, AFC, and CF are employees of Amaris Consulting; • FL has provided clinical advice to Janssen.
Ethics Approval Statement: The use of linked CPRD-HES-ONS-MHSDS data was approved by the CPRD Independent Scientific Advisory Committee (ISAC Protocol No. 19_091R2).
Keywords: Population-based study, Major depressive disorder, Suicide intent, England, Clinical practice research datalink (CPRD), Hospital episode statistics (HES), Mental health services data set (MHSDS), Office for National Statistics (ONS), Healthcare resource use
Suggested Citation: Suggested Citation