Wee Soon Nan, Liman Christian, Waters Heidi C, Houle Christy R, Renteria Miguel, Mukherjee Sankha S, Surendran Subina, Marcovici Joshua, Brubaker Malaak, Rasmussen Meehan Stine, de Jong-Laird Anne, Rush A John, Sarkar Joydeep
Holmusk Technologies, Inc, New York, NY, USA.
Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, USA.
Clinicoecon Outcomes Res. 2023 Mar 18;15:195-208. doi: 10.2147/CEOR.S395255. eCollection 2023.
Life engagement encompasses concepts such as life fulfillment, well-being, and participation in meaningful activities, encompassing cognitive, physical, social, and emotional dimensions. Patients with MDD experience impaired functioning across multiple domains of life engagement and have ranked concepts related to life engagement and fulfillment as important predictors of treatment success. Post-hoc analyses of three clinical trials of patients with MDD treated adjunctively with brexpiprazole have reported a significantly greater improvement in life engagement. This study investigated improvements in life engagement among patients with MDD following initiation of brexpiprazole treatment using a real-world dataset.
Information was extracted from semi-structured clinical notes of the Mental Status Examination (MSE) of patients in a real-world setting to develop an outcome measure for quantifying life engagement of psychiatric patients. Measures of life engagement and its four sub-domains (emotional, physical, social, and cognitive) were calculated at each clinical visit for 624 adult patients with MDD during the 6 months following brexpiprazole initiation. Paired t-tests assessed differences between the index event and time periods within 6 months of the index event. Kaplan-Meier survival analyses were used to quantify the improvement in life engagement scores following brexpiprazole initiation.
The study identified 54 clinical features associated with life engagement. Statistically significant improvements were observed from as early as 1 month following brexpiprazole initiation, with 20.6%, 37.9%, and 53.9% of the patients demonstrating improved life engagement scores within 1, 3, and 6 months, respectively. The improvements were particularly apparent for the emotional and social sub-domains.
The results of this study provide evidence of improved life engagement following brexpiprazole initiation in a real-world dataset.
生活参与涵盖生活满意度、幸福感以及参与有意义活动等概念,涉及认知、身体、社会和情感等多个维度。重度抑郁症(MDD)患者在生活参与的多个领域功能受损,且将与生活参与和满意度相关的概念列为治疗成功的重要预测因素。三项关于使用布雷哌唑辅助治疗MDD患者的临床试验的事后分析报告称,生活参与度有显著改善。本研究使用真实世界数据集调查了MDD患者开始使用布雷哌唑治疗后生活参与度的改善情况。
从真实环境中患者精神状态检查(MSE)的半结构化临床记录中提取信息,以制定一种用于量化精神科患者生活参与度的结局指标。在624例成年MDD患者开始使用布雷哌唑后的6个月内,每次临床就诊时计算生活参与度及其四个子领域(情感、身体、社会和认知)的指标。配对t检验评估指标事件与指标事件后6个月内各时间段之间的差异。采用Kaplan-Meier生存分析来量化开始使用布雷哌唑后生活参与度得分的改善情况。
该研究确定了54个与生活参与度相关的临床特征。早在开始使用布雷哌唑后1个月就观察到了具有统计学意义的改善,分别有20.6%、37.9%和53.9%的患者在1、3和6个月内生活参与度得分有所改善。这些改善在情感和社会子领域尤为明显。
本研究结果为在真实世界数据集中开始使用布雷哌唑后生活参与度得到改善提供了证据。