Depression Management Needed in Routine Clinical Practice for Working-Age Adults With RA

Data published in Arthritis highlight the importance of incorporating depression screening and management into the routine clinical care of patients with rheumatoid arthritis (RA) to reduce pain and functional limitations, improve quality of life, and lower direct and indirect healthcare costs.

A total of 647 working age (18 to 64 years) patients with RA and depression and 2015 patients with RA without depression were enrolled in the retrospective cross-sectional study. Researchers sought to estimate the excess clinical, humanistic, and economic burden associated with depression in individuals with RA. In their analysis, the investigators used data from the Medical Expenditure Panel Survey for years 2009, 2011, 2013, and 2015.

Results showed that 25.8% of study participants had depression. Based on adjusted analysis, patients with RA and depression vs patients with RA without depression were significantly more likely to experience severe pain interference with normal work (adjusted odds ratio [aOR], 2.22; 95% CI, 1.55-3.18; P <.00), functional limitations (aOR, 2.24; 95% CI, 1.62-3.10; P <.001), and lower health-related quality of life mental health scores.

In addition, adults with RA and depression had significantly higher yearly healthcare expenditures compared with adults with RA without depression ($14,752 vs $10,541, respectively; P <.001) and out-of-pocket spending burden (aOR, 1.34; 95% CI, 1.10-1.79; P <.01). Adults with RA and depression were more likely than adults with RA without depression to be unemployed. In employed adults with RA, adults with depression had a significantly higher number of missed worked days per year and higher lost annual wages due to missed worked days compared with adults with RA without depression (P <.05 for both).

The investigators concluded that additional studies are warranted to evaluate the potential cost reductions that can be obtained with early detection and more aggressive treatment of depression in individuals with RA.

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Reference

Deb A, Dwibedi N, LeMasters T, Hornsby JA, Wei W, Sambamoorthi U. Burden of depression among working-age adults with rheumatoid arthritis [published online June 3, 2018]. Arthritis. doi:10.1155/2018/8463632