PMH41 Health-Related Quality of Life of Type-2 Diabetic Patients with Diagnosed Depression, Undiagnosed Depression and No Depression in the United States: Medical Expenditure Panel Survey, 2016-2018

Abstract

The coexistence of diabetes and depression is associated with impairment of Health-Related Quality of Life (HRQoL). Many diabetic patients have undiagnosed depression, leaving the patient untreated and worsening the condition. Given the growing humanistic burden of depression, this study's objective was to examine the differences in the HRQoL of Type-2 diabetic patients with diagnosed, undiagnosed, and no depression. A retrospective, cross-sectional study design was implemented using Medical Expenditure Panel Survey data (2016-2018). Type-2 diabetic patients were stratified using the ICD-10-CM depression code and PHQ-2 screener: (1) Diagnosed (2) Undiagnosed (PHQ-2 ≥ 3 and no depression diagnosis) (3) No depression. HRQoL was measured using the Physical and Mental Component Summary(PCS and MCS) scores obtained from the SF-12v2/VR-12. Regression analysis was used to examine the impact of depression status on the HRQoL using the diagnosed depression group as the reference. We identified 7191(unweighted) adults with diabetes, 8.84% had undiagnosed depression, and 16.19% had diagnosed depression. A significantly higher proportion of patients under 125% of the poverty line were found in the undiagnosed group (47.01%) than the diagnosed (36.00%) and no depression group(23.67%). The mean and standard deviation of the HRQoL (MCS; PCS) scores were significantly lower in the diagnosed (41.4±11.41; 36.05±11.85) and undiagnosed ( 36.69±9.97; 31.63±10.73) group than no depression(52.9±8.52; 42.40±11.87). Results from regression analysis indicated that patients with undiagnosed depression had lower MCS (4.46 points; p<0.001) and PCS( 3.50 points; p<0.001) than those with diagnosed depression. Conversely, patients with no depression had higher MCS (10.24 points; p<0.001) and PCS( 3.74 points; p<0.001) than the diagnosed depression group. Timely diagnosis and treatment of undiagnosed depression in diabetic individuals are necessary to improve health outcomes. Optimal treatment of patients with diagnosed depression and access to appropriate mental healthcare services irrespective of income level is essential to achieve better HRQoL.