Journal of Multidisciplinary Healthcare (Apr 2021)
Economic and Humanistic Burden Associated with Depression and Anxiety Among Adults with Non-Communicable Chronic Diseases (NCCDs) in the United States
Abstract
Eric Armbrecht,1 Ruchit Shah,2 Gregory W Poorman,2 Linlin Luo,2 Jennifer M Stephens,2 Benjamin Li,3 Elizabeth Pappadopulos,4 Seema Haider,5 Roger S McIntyre6– 9 1Saint Louis University Center for Health Outcomes Research, Saint Louis University, Saint Louis, MO, USA; 2Pharmerit International, Bethesda, MD, USA; 3Pfizer Inc., New York, NY, USA; 4Viatris Inc., New York, NY, USA; 5Pfizer Inc., Groton, CT, USA; 6Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; 7Department of Psychiatry, University of Toronto, Toronto, ON, Canada; 8Department of Pharmacology, University of Toronto, Toronto, ON, Canada; 9Brain and Cognition Discovery Foundation, Toronto, ON, CanadaCorrespondence: Jennifer M StephensPharmerit International, 4350 East West Hwy #1100, Bethesda, MD, 20814, USATel +1-240-821-1290Email [email protected]: Patients with both major depressive disorder (MDD) and generalized anxiety disorder (GAD) in addition to one or multiple comorbid non-communicable chronic diseases (NCCDs) face unique challenges. However, few studies have characterized how the burden of co-occurring MDD and GAD differs from that of only MDD or only GAD among patients with NCCDs.Methods: In this study, we used Medical Expenditures Panel Survey data from 2010– 2017 to understand how the economic and humanistic burden of co-occurring MDD and GAD differs from that of MDD or GAD alone among patients with NCCDs. We used generalized linear models to investigate this relationship and controlled for patient sociodemographics and clinical characteristics.Results: Co-occurring MDD and GAD was associated with increases in mean annual per patient inpatient visits, office visits, emergency department visits, annual drug costs, and total medical costs. Among patients with 3+ NCCDs, MDD or GAD only was associated with lower odds ratios (ORs) of limitations in activities of daily living (ADLs; 0.532 and 0.508, respectively) and social (0.503, 0.526) and physical limitations (0.613, 0.613) compared to co-occurring MDD and GAD. Compared to patients with co-occurring MDD and GAD, having MDD only or GAD only was associated with significantly lower odds of cognitive limitations (0.659 and 0.461, respectively) in patients with 1– 2 NCCDs and patients with 3+ NCCDs (0.511, 0.416).Discussion: Comorbid MDD and GAD was associated with higher economic burden, lower quality of life, and greater limitations in daily living compared to MDD or GAD alone. Health-related economic and humanistic burden increased with number of NCCDs.Keywords: economic burden, humanistic burden, depression, anxiety, non-communicable diseases
