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Poster
1594755
Characterization of Care Patterns for Patients Newly Diagnosed With Major Depressive Disorder (MDD) in Primary Care Settings: a Retrospective Observational Cohort Study
Psych Congress 2023
This work was sponsored by CVS Health Clinical Trial Services, LLC, Woonsocket, RI, USA
Sage Therapeutics, Inc., Cambridge, MA USA
Biogen Inc., Cambridge, MA USA Background: Primary care providers (PCPs) are key clinicians in managing major depressive disorder (MDD). Methods: This retrospective cohort study used an insurer’s claims database. Patients (≥18 years) were included based on newly diagnosed MDD (ICD-10) recorded by a PCP or a Psychiatric provider (PSY) from 1/1/2019 to 12/31/2021, and followed for 12 months. Results: Among 18,767 eligible patients, 90.5% were first diagnosed and managed by PCPs; of those, only 6.2% transitioned care to PSY. PCP-managed patients were predominantly female (63.2%), White (61.2%), had a mean (SD) age of 55.8 (19.5) years, and 44% lived in rural areas. At baseline, 31.9% of PCP-managed patients were prescribed benzodiazepines, and 46% had ≥4 comorbidities, with hypertension (41.6%) being most prevalent. During follow-up, 28.6% of the PCP cohort remained untreated, 57.7% were only prescribed antidepressants, 3.9% received only psychotherapy, and 9.8% received both treatments. Among PCP-managed patients, 18.7% (Nf3184) were defined as severe MDD by ≥1 MDD-related ER visit (12.3%) or inpatient admission (5.3%), a diagnosis of severe MDD (6.1%), and/or suicide attempt/ideation (0.9%). Conclusion: The majority of newly diagnosed patients with MDD were treated exclusively by PCPs during one-year follow-up. More than one fourth of PCP-managed patients remained untreated. In addition, nearly one fifth were identified as having severe MDD, which may indicate the need for specialist management of their depression. Few MDD patients transitioned care from PCPs to psychiatry, indicating the need for further research to understand the root causes behind these observations and their implications for MDD care and medical events.
Sage Therapeutics, Inc., Cambridge, MA USA
Biogen Inc., Cambridge, MA USA Background: Primary care providers (PCPs) are key clinicians in managing major depressive disorder (MDD). Methods: This retrospective cohort study used an insurer’s claims database. Patients (≥18 years) were included based on newly diagnosed MDD (ICD-10) recorded by a PCP or a Psychiatric provider (PSY) from 1/1/2019 to 12/31/2021, and followed for 12 months. Results: Among 18,767 eligible patients, 90.5% were first diagnosed and managed by PCPs; of those, only 6.2% transitioned care to PSY. PCP-managed patients were predominantly female (63.2%), White (61.2%), had a mean (SD) age of 55.8 (19.5) years, and 44% lived in rural areas. At baseline, 31.9% of PCP-managed patients were prescribed benzodiazepines, and 46% had ≥4 comorbidities, with hypertension (41.6%) being most prevalent. During follow-up, 28.6% of the PCP cohort remained untreated, 57.7% were only prescribed antidepressants, 3.9% received only psychotherapy, and 9.8% received both treatments. Among PCP-managed patients, 18.7% (Nf3184) were defined as severe MDD by ≥1 MDD-related ER visit (12.3%) or inpatient admission (5.3%), a diagnosis of severe MDD (6.1%), and/or suicide attempt/ideation (0.9%). Conclusion: The majority of newly diagnosed patients with MDD were treated exclusively by PCPs during one-year follow-up. More than one fourth of PCP-managed patients remained untreated. In addition, nearly one fifth were identified as having severe MDD, which may indicate the need for specialist management of their depression. Few MDD patients transitioned care from PCPs to psychiatry, indicating the need for further research to understand the root causes behind these observations and their implications for MDD care and medical events.
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