Health-related quality of life burden associated with treatment-resistant depression in UK patients: Quantitative results from a mixed-methods non-interventional study

TY - JOUR

T1 - Health-related quality of life burden associated with treatment-resistant depression in UK patients: Quantitative results from a mixed-methods non-interventional study

AU - Rathod, Shanaya

AU - Denee, Tom

AU - Eva, Joe

AU - Kerr, Cicely

AU - Jacobsen, Nicholas

AU - Desai, Mitesh

AU - Baldock, Laura

AU - Young, Allan H

N1 - Funding Information: SR reports grants from Janssen paid to Southern Health NHS Foundation Trust, during the conduct of the study; other educational support from Otsuka, Lundbeck, and Janssen, outside the submitted work.; TD and CK are employees of Johnson and Johnson with stock options.; JE and LB are employees of OPEN VIE Ltd, doing business as Open Health.; NJ reports grants from Janssen paid to their institution, during the conduct of the study. No other conflicts of interest to disclose.; MD: Was an employee of Johnson & Johnson when informing study design.; AY: Employed by King's College London; Honorary Consultant SLaM (NHS UK); Deputy Editor, BJPsych Open; Paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Astrazeneca, Eli Lilly, Lundbeck, Sunovion, Servier, LivaNova, Janssen, Allergan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage; Consultant to Johnson & Johnson; Consultant to LivaNova; Received honoraria for attending advisory boards and presenting talks at meetings organised by LivaNova; Principal Investigator in the Restore-Life VNS registry study funded by LivaNova; Principal Investigator on ESKETINTRD3004: “An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression”; Principal Investigator on “The Effects of Psilocybin on Cognitive Function in Healthy Participants”; Principal Investigator on “The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)”; UK Chief Investigator for Novartis MDD study MIJ821A12201; Grant funding (past and present): NIMH (USA), CIHR (Canada), NARSAD (USA), Stanley Medical Research Institute (USA), MRC (UK), Wellcome Trust (UK), Royal College of Physicians (Edin), BMA (UK), UBC-VGH Foundation (Canada); WEDC (Canada), CCS Depression Research Fund (Canada), MSFHR (Canada), NIHR (UK), Janssen (UK); No shareholdings in pharmaceutical companies. Funding Information: Professor Young's independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Funding Information: This study was funded by Janssen-Cilag Ltd. Publisher Copyright: © 2021

PY - 2022/3/1

Y1 - 2022/3/1

N2 - Background: Major depressive disorder (MDD) and its more intractable variant, treatment-resistant depression (TRD), are common conditions that adversely affect patient well-being and health-related quality of life (HRQoL). This study aimed to quantify the impact of MDD and particularly TRD on the HRQoL, functioning and productivity of UK patients to support clinical and reimbursement decisions and policymaking. Methods: 148 patients with clinician-verified symptomatic (non-treatment-resistant) MDD (Patients-MDD; n = 61) or TRD (Patients-TRD; n = 87) were recruited from ten clinical sites. Participants completed validated patient-reported outcome measures assessing depressive symptom severity (Patient Health Questionnaire-9 [PHQ-9]), HRQoL (EQ-5D-5 L/abbreviated World Health Organization Quality of Life Questionnaire [WHOQOL-BREF]) and work productivity/activity impairment (WPAI:D). Results: Patients-TRD and Patients-MDD reported similar levels of depressive symptom severity (mean PHQ-9 16.2/16.6, respectively). However, HRQoL was significantly poorer for Patients-TRD compared with Patients-MDD, both in the overall cohort (median EQ-5D-5 L utility 0.606/0.721, respectively [p = 0.021]; WHOQOL-BREF overall score 55.2/58.8 [p = 0.024]) and in patients with a PHQ-9 score ≥15 (median EQ-5D-5 L utility 0.415/0.705, respectively [p<0.001]). Although a numerically lower proportion of Patients-TRD were employed (45% vs 57% of Patients-MDD; p = 0.204), employed Patients-MDD reported significantly higher absenteeism and work productivity loss. Limitations: A minority of patients screened as having symptomatic MDD or TRD self-reported low PHQ-9 symptom severity. This was addressed with a subgroup analysis of patients with more severe depression. Conclusions: TRD is associated with an added patient HRQoL burden, above that observed for non-treatment-resistant MDD. This highlights the unmet need for greater access to improved treatment, including new treatment options for Patients-TRD.

AB - Background: Major depressive disorder (MDD) and its more intractable variant, treatment-resistant depression (TRD), are common conditions that adversely affect patient well-being and health-related quality of life (HRQoL). This study aimed to quantify the impact of MDD and particularly TRD on the HRQoL, functioning and productivity of UK patients to support clinical and reimbursement decisions and policymaking. Methods: 148 patients with clinician-verified symptomatic (non-treatment-resistant) MDD (Patients-MDD; n = 61) or TRD (Patients-TRD; n = 87) were recruited from ten clinical sites. Participants completed validated patient-reported outcome measures assessing depressive symptom severity (Patient Health Questionnaire-9 [PHQ-9]), HRQoL (EQ-5D-5 L/abbreviated World Health Organization Quality of Life Questionnaire [WHOQOL-BREF]) and work productivity/activity impairment (WPAI:D). Results: Patients-TRD and Patients-MDD reported similar levels of depressive symptom severity (mean PHQ-9 16.2/16.6, respectively). However, HRQoL was significantly poorer for Patients-TRD compared with Patients-MDD, both in the overall cohort (median EQ-5D-5 L utility 0.606/0.721, respectively [p = 0.021]; WHOQOL-BREF overall score 55.2/58.8 [p = 0.024]) and in patients with a PHQ-9 score ≥15 (median EQ-5D-5 L utility 0.415/0.705, respectively [p<0.001]). Although a numerically lower proportion of Patients-TRD were employed (45% vs 57% of Patients-MDD; p = 0.204), employed Patients-MDD reported significantly higher absenteeism and work productivity loss. Limitations: A minority of patients screened as having symptomatic MDD or TRD self-reported low PHQ-9 symptom severity. This was addressed with a subgroup analysis of patients with more severe depression. Conclusions: TRD is associated with an added patient HRQoL burden, above that observed for non-treatment-resistant MDD. This highlights the unmet need for greater access to improved treatment, including new treatment options for Patients-TRD.

KW - Health-related quality of life

KW - Activity impairment

KW - Major depressive disorder

KW - Treatment-resistant depression

KW - Work impairment

UR - http://www.scopus.com/inward/record.url?scp=85122642735&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2021.12.090

DO - 10.1016/j.jad.2021.12.090

M3 - Article

C2 - 34965398

SN - 0165-0327

VL - 300

SP - 551

EP - 562

JO - Journal of affective disorders

JF - Journal of affective disorders

ER -