POSA152 Characterising Patients with Major Depressive Disorder with Moderate-to-High Suicide Intent and Their Healthcare Resource Utilisation in England

Abstract

To characterise patients with major depressive disorder (MDD) with moderate-to-high-suicide-intent in England, compare their healthcare resource utilisation (HCRU) to MDD patients without moderate-to-high-suicide-intent, and better understand their patient pathways. This retrospective cohort study used primary care electronic health records from the Clinical Practice Research Datalink (CPRD), linked to Hospital Episode Statistics (HES) and the Mental Health Dataset in England. Adults with ≥1 MDD diagnosis between 4/2007-11/2015 were included and categorised by suicide intent. MDD patients with moderate-to-high-suicide-intent were followed from their initial suicide intent diagnosis, whereas MDD patients without moderate-to-high-suicide-intent were followed from their first MDD diagnosis. Patients with psychosis, schizophrenia, mania, bipolar disorder, or dementia were excluded. 307,476 patients were included (294,259 MDD patients without moderate-to-high-suicide-intent and 13,217 MDD patients with moderate-to-high-suicide-intent). MDD patients with moderate-to-high-suicide-intent were younger on average and had a lower proportion of females than patients without moderate-to-high-suicide-intent (age: 39.0 versus 44.8 years; female: 58% versus 65%). The average number of outpatient visits was greater among MDD patients with moderate-to-high-suicide-intent than patients without moderate-to-high-suicide-intent during the first follow-up year for the following: general practitioner consultations (38.5 versus 29.4), psychiatric outpatient visits (1.5 versus 0.1), psychiatrist visits (3.6 versus 0.3), and accident and emergency visits (1.5 versus 0.3). Approximately 86% of MDD patients with moderate-to-high-suicide-intent were hospitalised during the first follow-up year compared with 26% of patients without moderate-to-high-suicide-intent (average duration: 3.2 and 2.8 days, respectively). A total of 56% of MDD patients with moderate-to-high-suicide-intent had an antidepressant prescription within 30 days of the index date, with citalopram being the most frequently prescribed. This study provides novel results on the patient characteristics, healthcare resource utilisation, and patient pathways among MDD patients with moderate-to-high-suicide-intent in England. These results indicate the need for new treatments that can achieve a rapid therapeutic response and reduce HCRU.