Characterizing the treatment patterns, medication burden, and patient demographics of older adults with major depressive disorder treated with antidepressants with or without selected comorbidities

Laxmi Gannu; Francesca Devine; Lyuba Popadic; Sagar Lal; Michael Witte; Marci Potter; Steve Hass

doi:10.1080/03007995.2024.2348603

Characterizing the treatment patterns, medication burden, and patient demographics of older adults with major depressive disorder treated with antidepressants with or without selected comorbidities

Curr Med Res Opin. 2024 May 16:1-12. doi: 10.1080/03007995.2024.2348603. Online ahead of print.

Authors

Laxmi Gannu¹, Francesca Devine², Lyuba Popadic², Sagar Lal², Michael Witte³, Marci Potter⁴, Steve Hass¹

Affiliations

¹ HEOR Real-World Evidence (RWE), Sage Therapeutics, Inc., Cambridge, MA, USA.
² HEOR, Komodo Health, Inc., San Francisco, CA, USA.
³ Global Medical Affairs, Sage Therapeutics, Inc., Cambridge, MA, USA.
⁴ Neuropsychiatry, US Medical, Biogen Inc, Cambridge, MA, USA.

PMID: 38693906
DOI: 10.1080/03007995.2024.2348603

Abstract

Objective: Evaluate clinical characteristics, comorbidity burden, major depressive disorder (MDD)-related healthcare resource utilization (HCRU), medication burden, and antidepressant treatment (ADT) patterns among older adults with MDD with and without selected comorbidities.

Methods: Using Komodo's Healthcare Map claims data (1/1/2016-9/30/2022), patients with MDD (≥65 years) treated with ADTs were assessed 24 months preceding (baseline) and 12 months following (follow-up) first observed ADT prescription fill (index). Patients were separated into cohorts of those with ≥1 of 5 selected comorbidities and those without. Clinical characteristics, comorbidities, and MDD-related HCRU were assessed during baseline; treatment patterns were assessed during follow-up. Baseline and follow-up all-cause and comorbidity-specific medication burdens (mean prescription claims/month) were determined.

Results: Among the total cohort (N = 417,643), 97.1% had ≥1 of 5 selected comorbidities: hypertension (80.3%), hyperlipidemia (75.4%), diabetes (54.2%), anxiety disorder (39.0%), and chronic obstructive pulmonary disorder (19.5%). Baseline and follow-up all-cause medication burdens per month were 3.8 and 4.5 for patients with selected comorbidities and 1.7 and 2.3 for those without. During baseline, most patients (96.0% with selected comorbidities, 96.2% without) had ≥1 outpatient visit, and a numerically higher percentage of those with vs. without selected comorbidities had MDD-related emergency room (13.9% vs. 6.0%) and inpatient (13.5% vs. 4.1%) visits. The majority of both cohorts (61.0% with selected comorbidities, 59.5% without) underwent treatment pattern changes.

Conclusion: This study highlights the medication burden and ADT patterns in older adults with MDD, assessing these outcomes among patients with and without comorbidities. Numerically higher medication burdens among those with selected comorbidities suggests future studies could investigate the impact of comorbidities on MDD-related care.

Keywords: Depression (MDD); age ≥65 years; antidepressant treatment (ADT) patterns; comorbidity burden; healthcare resource utilization (HCRU); medication burden.