Effect of inadequate response to treatment in patients with depression.
OBJECTIVE
To assess the effects of inadequate response to antidepressant treatment on healthcare resource utilization and on work productivity in patients diagnosed as having major depressive disorder (MDD).


METHODS
This study used data from the 2006 US National Health and Wellness Survey, a cross-sectional survey of adults 18 years and older.


METHODS
Patients who self-reported a confirmed diagnosis of depression and were currently taking antidepressant medication were included in the analyses. Adequacy of antidepressant treatment response was determined from responses to the mental health domain of the 8-Item Short Form Health Survey (SF-8). Logistic regression analyses adjusted for demographics, comorbidity, and component scores on the SF-8 were used to determine the associations between inadequacy of treatment response and health outcomes.


RESULTS
Of 5988 patients who met the inclusion criteria for the study, 30.9% were classified as antidepressant treatment responders, 31.2% were partial responders, and 37.9% were nonresponders. Partial response and nonresponse to treatment were associated with greater likelihood of emergency department utilization (odds ratios [ORs], 1.26 and 1.54, respectively; P <.01 for both) and hospitalization (OR, 1.23; P = .05 and OR, 1.39; P <.01, respectively). Similarly, partial response and nonresponse were associated with lower likelihood of current employment (OR, 0.83; P = .01 and OR, 0.63; P <.01, respectively) and with greater likelihood of work productivity loss among the employed (ORs, 1.42 and 1.99, respectively; P <.01 for both).


CONCLUSIONS
Patients with MDD who failed to respond to antidepressant treatment as evidenced by poor self-reported mental health status used more healthcare resources, were less likely to be employed, and had more work productivity loss than those who responded to antidepressant therapy.
Knoth
Russell L
RL
Bristol-Myers Squibb, Plainsboro, NJ, USA.
Bolge
Susan C
SC
Kim
Edward
E
Tran
Quynh-Van
QV
D000041:Absenteeism; D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use*; D015897:Comorbidity / Q000639:trends; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy* / Q000191:economics; D004526:Efficiency; D017048:Health Care Costs; D019538:Health Care Surveys; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008603:Mental Health / Q000706:statistics & numerical data; D016017:Odds Ratio; D011594:Psychometrics; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014481:United States
D000928:Antidepressive Agents