Improving Mental Health Outcomes in Patients with Major Depressive Disorder in the Gulf States: A Review of the Role of Electronic Enablers in Monitoring Residual Symptoms

Abstract

Nahida Nayaz Ahmed,1,* Shuja Reagu,2,* Samia Alkhoori,3 Amina Cherchali,4 Pradeep Purushottamahanti,5 Urooj Siddiqui4 1SEHA Mental Health & Wellbeing Services, College of Medicine and Health Sciences of the United Arab Emirates University, Abu Dhabi, United Arab Emirates; 2Weill Cornell Medicine, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar; 3Rashid Hospital, Dubai Health, Dubai, United Arab Emirates; 4Viatris Middle East FZ-LLC, Dubai, United Arab Emirates; 5Global Medical Affairs, Viatris Inc., Bangalore, India*These authors contributed equally to this workCorrespondence: Pradeep Purushottamahanti, Psychiatry Medical Lead, Global Medical Affairs, Viatris, 11th Floor, Prestige Tech Park Platina-3, Kadubeesanahalli, Bengaluru, 560103, India, Email [email protected]: Up to 75% of individuals with major depressive disorder (MDD) may have residual symptoms such as amotivation or anhedonia, which prevent full functional recovery and are associated with relapse. Globally and in the Gulf region, primary care physicians (PCPs) have an important role in alleviating stigma and in identifying and monitoring the residual symptoms of depression, as PCPs are the preliminary interface between patients and specialists in the collaborative care model. Therefore, mental healthcare upskilling programmes for PCPs are needed, as are basic instruments to evaluate residual symptoms swiftly and accurately in primary care. Currently, few if any electronic enablers have been designed to specifically monitor residual symptoms in patients with MDD. The objectives of this review are to highlight how accurate evaluation of residual symptoms with an easy-to-use electronic enabler in primary care may improve functional recovery and overall mental health outcomes, and how such an enabler may guide pharmacotherapy selection and positively impact the patient journey. Here, we show the potential advantages of electronic enablers in primary care, which include the possibility for a deeper “dive” into the patient journey and facilitation of treatment optimisation. At the policy and practice levels, electronic enablers endorsed by government agencies and local psychiatric associations may receive greater PCP attention and backing, improve patient involvement in shared clinical decision-making, and help to reduce the general stigma around mental health disorders. In the Gulf region, an easy-to-use electronic enabler in primary care, incorporating aspects of the Hamilton Depression Rating Scale to monitor amotivation, and aspects of the Montgomery-Åsberg Depression Rating Scale to monitor anhedonia, could markedly improve the patient journey from residual symptoms through to full functional recovery in individuals with MDD.Keywords: electronic tools, functional recovery, knowledge gaps, major depression, primary care, residual outcomes

Keywords

• electronic tools
• functional recovery
• knowledge gaps
• major depression
• primary care
• residual outcomes