NDLI: Impacto de la morbilidad, uso de recursos y costes en el mantenimiento de la remisión de la depresión mayor en España: estudio longitudinal de ámbito poblacional.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sicras-Mainar, Antoni Blanca-Tamayo, Milagrosa Gutiérrez-Nicuesa, Laura Salvatella-Pasant, Jordi Navarro-Artieda, Ruth
Spatial Coverage	Spain
Description	Author Affiliation: Sicras-Mainar A ( Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, España. asicras@bsa.cat)
Abstract	OBJECTIVE: To determinate the impact of comorbidity, resource use and cost (healthcare and lost productivity) on maintenance of remission of major depressive disorder in a Spanish population setting. METHODS: We performed an observational, prospective, multicenter study using population databases. The inclusion criteria were age > or = 18 years, first depressive episode between January 2003 and March 2007, with antidepressant prescription >60 days after the first prescription and a follow-up of at least 18 months (study: 12 months; continuation: 6 months). Two subgroups were considered: patients with/without remission. MAIN MEASURES: sociodemographic data, episodes, resource utilization bands, healthcare costs (direct) and lost productivity (indirect). Logistic regression and analysis of covariance (Bonferroni correction) were used for analysis. RESULTS: A total of 4,572 patients were analyzed and 54.6% (95% confidence interval: 53.2-56.0%) were considered in remission. Patients in remission were younger (52.6 vs. 60.7), with a lower proportion of women (71.7% vs. 78.2%), and showed less general morbidity (6.2 vs. 7.7 episodes/year), lower resource utilization bands/year (2.7 vs. 3.0), fewer sick leave days (31.0 vs. 38.5) and shorter treatment duration (146.6 vs. 307.7 days); p<0.01. Lack of remission was associated with fibromyalgia (odds ratio [OR]=2.5), thyroid alterations (OR=1.3) and hypertension (OR=1.2); p<0.001. The annual healthcare cost was euro706.0 per patient in remission vs. euro1,108.3 without remission (p <0.001) and lost productivity was euro1,631.5 vs. euro2,024.2, respectively (p <0.001). CONCLUSIONS: Patients not achieving remission showed higher morbidity, resources use, healthcare costs and, especially, productivity losses.
Related Links	http://www.scielosp.org/scielo.php?script=sci_arttext&nrm=iso&lng=pt&tlng=pt&pid=S0213-91112010000100003
File Format	HTM / HTML
ISSN	02139111
Issue Number	1
Volume Number	24
e-ISSN	15781283
Journal	Gaceta Sanitaria
Language	Spanish
Publisher	Elsevier
Publisher Date	2010-01-01
Publisher Place	Spain
Access Restriction	Subscribed
Subject Keyword	Discipline Public Health Depressive Disorder, Major Epidemiology Absenteeism Adolescent Adult Aged Aged, 80 And Over Antidepressive Agents Economics Therapeutic Use Comorbidity Confidentiality Cost Of Illness Female Health Care Costs Statistics & Numerical Data Health Resources Utilization Humans Male Middle Aged Models, Theoretical Prescription Fees Prospective Studies Spain Young Adult English Abstract Journal Article Multicenter Study
Alternative Title	Impact of morbidity, resource use and costs on maintenance of remission of major depression in Spain: a longitudinal study in a population setting
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health

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