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患有类风湿关节炎的工作年龄成年人的抑郁症负担

Burden of Depression among Working-Age Adults with Rheumatoid Arthritis.

作者信息

Deb Arijita, Dwibedi Nilanjana, LeMasters Traci, Hornsby Jo Ann, Wei Wenhui, Sambamoorthi Usha

机构信息

School of Pharmacy, Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV, USA.

School of Medicine, West Virginia University, Morgantown, WV, USA.

出版信息

Arthritis. 2018 Jun 3;2018:8463632. doi: 10.1155/2018/8463632. eCollection 2018.

Abstract

OBJECTIVE

This study estimated the excess clinical, humanistic, and economic burden associated with depression among working-age adults with Rheumatoid Arthritis (RA).

METHODS

A retrospective cross-sectional study was conducted among working-age (18 to 64 years) RA patients with depression ( = 647) and without depression ( = 2,015) using data from the nationally representative Medical Expenditure Panel Survey for the years 2009, 2011, 2013, and 2015.

RESULTS

Overall, 25.8% had depression. In adjusted analyses, adults with RA and depression compared to those without depression were significantly more likely to have pain interference with normal work (severe pain: AOR = 2.22; 95% CI = 1.55, 3.18), functional limitations (AOR = 2.17; 95% CI = 1.61, 2.94), and lower mental health HRQoL scores. Adults with RA and depression had significantly higher annual healthcare expenditures ($14,752 versus 10,541, < .001) and out-of-pocket spending burden. Adults with RA and depression were more likely to be unemployed and among employed adults, those with depression had a significantly higher number of missed work days annually and higher lost annual wages due to missed work days.

CONCLUSIONS

This study highlights the importance of effectively managing depression in routine clinical practice of RA patients to reduce pain and functional limitations, improve quality of life, and lower direct and indirect healthcare costs.

摘要

目的

本研究评估了类风湿关节炎(RA)患者中抑郁症给工作年龄成年人带来的额外临床、人文和经济负担。

方法

利用2009年、2011年、2013年和2015年具有全国代表性的医疗支出面板调查数据,对工作年龄(18至64岁)的RA患者进行了一项回顾性横断面研究,其中有抑郁症的患者(n = 647),无抑郁症的患者(n = 2015)。

结果

总体而言,25.8%的患者患有抑郁症。在调整分析中,与无抑郁症的成年人相比,患有RA且伴有抑郁症的成年人更有可能出现疼痛干扰正常工作(重度疼痛:调整后比值比[AOR]=2.22;95%置信区间[CI]=1.55,3.18)、功能受限(AOR = 2.17;95% CI = 1.61,2.94)以及较低的心理健康健康相关生活质量(HRQoL)得分。患有RA且伴有抑郁症的成年人年度医疗保健支出显著更高(14,752美元对10,541美元,P <.001),自付费用负担也更高。患有RA且伴有抑郁症的成年人更有可能失业,在就业成年人中,患有抑郁症的人每年旷工天数显著更多,因旷工导致的年度工资损失也更高。

结论

本研究强调了在RA患者的常规临床实践中有效管理抑郁症的重要性,以减轻疼痛和功能受限,改善生活质量,并降低直接和间接医疗成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb32/6008693/c502369ec149/ARTHRITIS2018-8463632.001.jpg

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