2026-06-14T02:28:08Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/231862024-11-28T17:42:26Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16961col_20.500.12105_16967col_20.500.12105_16974col_20.500.12105_16983

00925njm 22002777a 4500 dc Perez-Sola, Victor author Roca, Miquel author Alonso, Jordi author Gabilondo, Andrea author Hernando, Teresa author Sicras-Mainar, Antoni author Sicras-Navarro, Aram author Herrera, Berta author Vieta, Eduard author 2021-12-01 Background: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. Methods: A retrospective, observational-study was carried out using data from the BIG-PAC database (R). Patients aged ≥ 18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with ≥ 2 antidepressants including the prescription of ≥ 3 antidepressants (N06A) or ≥ 2 antidepressant and ≥ 1 antipsychotic (N05A; including lithium) b) antidepressants administered for ≥ 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was ≤ 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. Outcomes: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). Results: 21,630 patients with MDD aged ≥ 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 personyears, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were €4,147.9, being higher for TRD than for non-TRD patients (€6,096 vs. €3,846; p<0.001): a) direct costs (€1,341 vs. €624; p<0.001), b) lost productivity (€1,274 vs. €821; p<0.001) and c) permanent disability (€3,481 vs. €2,401; p<0.001, adjusted). Sensitivity analyses showed no differences with the reported results. Conclusions: The population based TRD incidence in Spain was similar to recent data from other European countries. TRD is associated with greater resource use and higher costs compared with non-TRD patients. Perez-Sola V, Roca M, Alonso J, Gabilondo A, Hernando T, Sicras-Mainar A, et al. Economic impact of treatment-resistant depression: A retrospective observational study. J Affect Disord. 2021 Dec 1;295:578-86. 10.1016/j.jad.2021.08.036 1573-2517 0165-0327 Journal of Affective Disorders https://hdl.handle.net/20.500.13003/19552 34509073 L2014473833 2-s2.0-85114488478 https://hdl.handle.net/20.500.12105/23186 741334700073 Treatment-resistant depression Major depressive disorder Incidence Economic burden Economic impact of treatment-resistant depression: A retrospective observational study