1
|
Hidalgo-Fuentes S, Caro-Cañizares I, Izquierdo-Sotorrío E. Frequency of suicidal ideation inventory: A reliability generalization meta-analysis. DEATH STUDIES 2024:1-12. [PMID: 39141592 DOI: 10.1080/07481187.2024.2390904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
The objectives of this reliability generalization meta-analysis were to estimate the overall reliability of the Frequency of Suicidal Ideation Inventory (FSII), a short, easily administered test developed to assess suicidal ideation and to examine possible moderating variables. A systematic search was conducted in five databases from the year of publication (2016) of the FSII until March 2024. All studies that applied the FSII and reported a Cronbach's alpha coefficient were included. Analyses were performed using a random effects model applying Bonett's transformation. Our analysis of 32 studies (k = 39) yielded an overall alpha of .91 (95% CI = .90, .92). We found that the type of administration, population, and language of the FSII moderated its reliability, which is high overall and appropriate for use in both research and clinical settings.
Collapse
Affiliation(s)
- Sergio Hidalgo-Fuentes
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
- Departamento de Psicología Básica, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
| | - Irene Caro-Cañizares
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
| | - Eva Izquierdo-Sotorrío
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Collado Villalba, Madrid, Spain
| |
Collapse
|
2
|
Rush E, Ozmen O, Kim M, Ortegon ER, Jones M, Park BH, Pizer S, Trafton J, Brenner LA, Ward M, Nebeker JR. A framework for inferring and analyzing pharmacotherapy treatment patterns. BMC Med Inform Decis Mak 2024; 24:68. [PMID: 38459459 PMCID: PMC10924394 DOI: 10.1186/s12911-024-02469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND To discover pharmacotherapy prescription patterns and their statistical associations with outcomes through a clinical pathway inference framework applied to real-world data. METHODS We apply machine learning steps in our framework using a 2006 to 2020 cohort of veterans with major depressive disorder (MDD). Outpatient antidepressant pharmacy fills, dispensed inpatient antidepressant medications, emergency department visits, self-harm, and all-cause mortality data were extracted from the Department of Veterans Affairs Corporate Data Warehouse. RESULTS Our MDD cohort consisted of 252,179 individuals. During the study period there were 98,417 emergency department visits, 1,016 cases of self-harm, and 1,507 deaths from all causes. The top ten prescription patterns accounted for 69.3% of the data for individuals starting antidepressants at the fluoxetine equivalent of 20-39 mg. Additionally, we found associations between outcomes and dosage change. CONCLUSIONS For 252,179 Veterans who served in Iraq and Afghanistan with subsequent MDD noted in their electronic medical records, we documented and described the major pharmacotherapy prescription patterns implemented by Veterans Health Administration providers. Ten patterns accounted for almost 70% of the data. Associations between antidepressant usage and outcomes in observational data may be confounded. The low numbers of adverse events, especially those associated with all-cause mortality, make our calculations imprecise. Furthermore, our outcomes are also indications for both disease and treatment. Despite these limitations, we demonstrate the usefulness of our framework in providing operational insight into clinical practice, and our results underscore the need for increased monitoring during critical points of treatment.
Collapse
Affiliation(s)
- Everett Rush
- Oak Ridge National Laboratory, Oak Ridge, TN, USA.
| | - Ozgur Ozmen
- Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Minsu Kim
- Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | | | - Makoto Jones
- US Department of Veterans Affairs, Washington DC, USA
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Byung H Park
- Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | | | | | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center, Aurora, CO, USA
| | - Merry Ward
- US Department of Veterans Affairs, Washington DC, USA
| | - Jonathan R Nebeker
- US Department of Veterans Affairs, Washington DC, USA
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
3
|
Berardelli I, Sarubbi S, Rogante E, Erbuto D, Cifrodelli M, Giuliani C, Calabrò G, Lester D, Innamorati M, Pompili M. Exploring risk factors for re-hospitalization in a psychiatric inpatient setting: a retrospective naturalistic study. BMC Psychiatry 2022; 22:821. [PMID: 36550540 PMCID: PMC9783999 DOI: 10.1186/s12888-022-04472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The reduction of multiple psychiatric hospitalizations is an important clinical challenge in mental health care. In fact, psychiatric re-hospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders. For these reasons, identifying predictors of re-hospitalization is important for better managing psychiatric patients. The first purpose of the present study was to examine the readmission rate in a large sample of inpatients with a psychiatric disorder. Second, we investigated the role of several demographical and clinical features impacting re-hospitalization. METHOD: This retrospective study enrolled 1001 adult inpatients (510 men and 491 women) consecutively admitted to the University Psychiatric Clinic, Sant'Andrea Hospital, Sapienza University of Rome between January 2018 and January 2022. To identify risk factors for psychiatric re-hospitalization, we divided the sample into 3 subgroups: the Zero-Re group which had no readmission after the index hospitalization, the One-Re group with patients re-admitted only once, and the Two-Re with at least two re-admissions. RESULTS: The groups differed according to previous hospitalizations, a history of suicide attempts, age at onset, and length of stay. Furthermore, the results of the regression model demonstrated that the Two-Re group was more likely to have a history of suicide attempts and previous hospitalizations. DISCUSSION These results indicate the importance of assessing risk factors in psychiatric hospitalized patients and implementing ad hoc prevention strategies for reducing subsequent re-hospitalizations.
Collapse
Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Faculty of Medicine and Psychology, Suicide Prevention Centre, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Via Di Grottarossa, 1035, 00189, Rome, Italy.
| | - Salvatore Sarubbi
- grid.7841.aDepartment of Human Neurosciences, Sapienza University of Rome, Viale Dell’Università, 30, 00185 Rome, Italy
| | - Elena Rogante
- grid.7841.aDepartment of Human Neurosciences, Sapienza University of Rome, Viale Dell’Università, 30, 00185 Rome, Italy
| | - Denise Erbuto
- grid.7841.aDepartment of Neurosciences, Faculty of Medicine and Psychology, Suicide Prevention Centre, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, Via Di Grottarossa, 1035, 00189 Rome, Italy
| | - Mariarosaria Cifrodelli
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant’Andrea Hospital, Psychiatry Unit, Via Di Grottarossa, 1035, 00189 Rome, Italy
| | - Carlotta Giuliani
- grid.7841.aPsychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant’Andrea Hospital, Psychiatry Unit, Via Di Grottarossa, 1035, 00189 Rome, Italy
| | - Giuseppa Calabrò
- grid.7841.aDepartment of Neurosciences, Faculty of Medicine and Psychology, Suicide Prevention Centre, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, Via Di Grottarossa, 1035, 00189 Rome, Italy
| | - David Lester
- grid.262550.60000 0001 2231 9854Psychology Program, Stockton University, Galloway, NJ USA
| | - Marco Innamorati
- grid.459490.50000 0000 8789 9792Department of Human Sciences, European University of Rome, Via Degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Maurizio Pompili
- grid.7841.aDepartment of Neurosciences, Faculty of Medicine and Psychology, Suicide Prevention Centre, Mental Health and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, Via Di Grottarossa, 1035, 00189 Rome, Italy
| |
Collapse
|
4
|
Karkare S, Zhdanava M, Pilon D, Nash AI, Morrison L, Shah A, Lefebvre P, Joshi K. Characteristics of Real-World Commercially Insured Patients With Treatment-Resistant Depression Initiated on Esketamine Nasal Spray or Conventional Therapies in the United States. Clin Ther 2022; 44:1432-1448. [DOI: 10.1016/j.clinthera.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/31/2022] [Accepted: 09/08/2022] [Indexed: 11/03/2022]
|
5
|
Neslusan C, Chopra I, Joshi K, Voelker J. Clinical and economic burden of major depressive disorder with acute suicidal ideation or behavior in a US Veterans Health Affairs database. Curr Med Res Opin 2022; 38:1603-1611. [PMID: 35670276 DOI: 10.1080/03007995.2022.2081452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Although a high incidence of major depressive disorder (MDD) and an increased risk of suicide are observed among the veteran population, there are yet limited real-world data characterizing patients with MDD with acute suicidal ideation/behavior (MDSI) in the Veterans Health Administration (VHA) system. We assessed the clinical and economic burden, including comorbidities, treatment patterns, health care resource utilization, and health care costs, among veterans and their family members with MDSI within the VHA system. METHODS This retrospective, longitudinal analysis of VHA datasets (10/1/2015-3/31/2018) evaluated the clinical and economic burden associated with MDSI and compared this population with matched MDD alone (i.e. MDD diagnosis without acute suicidal ideation/behavior) and non-MDD (i.e. neither MDD nor acute suicidal ideation/behavior) cohorts. RESULTS Among 11,203 patients with MDSI, the proportions of patients who filled a prescription for ≥1 antidepressant during the 12-month pre- and 6-month post-periods were significantly higher compared with patients with MDD alone (53.7% vs 28.8%, p < .05; and 72.3% vs 44.1%, p < .05; respectively). During the 12-month pre-period, the MDSI cohort had the highest proportion of patients with ≥1 mental health-related inpatient visit compared with the MDD alone and non-MDD cohorts (13.2% vs 2.3% vs 1.4%, respectively; p < .05), and the highest mental health-related costs per patient ($8853 vs $1913 vs $1079, respectively). For the 6-month post-period, the MDSI cohort had the highest proportion of patients with ≥1 mental health-related inpatient visit compared with the MDD alone and non-MDD cohorts (60.4% vs 7.9% vs 0.8%, respectively; p < .05), and had the highest mental health-related costs per patient ($20,334 vs $4803 vs $545, respectively). CONCLUSIONS Findings demonstrate significant clinical and economic burden for those in the VHA system diagnosed with MDSI and highlight unmet needs and opportunities for improving the care of this vulnerable group.
Collapse
Affiliation(s)
| | | | - Kruti Joshi
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | | |
Collapse
|
6
|
Excess healthcare resource utilization and healthcare costs among privately and publicly insured patients with major depressive disorder and acute suicidal ideation or behavior in the United States. J Affect Disord 2022; 311:303-310. [PMID: 35597466 DOI: 10.1016/j.jad.2022.05.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/25/2022] [Accepted: 05/15/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND This study assessed the healthcare resource utilization (HRU) and cost burden of patients with major depressive disorder (MDD) and acute suicidal ideation or behavior (SIB; MDSI) versus those with MDD without SIB and those without MDD. METHODS Adults were selected from the MarketScan® Databases (10/2015-02/2020). The MDSI cohort received an MDD diagnosis within 6 months of a claim for acute SIB (index date). The index date was a random MDD claim in the MDD without SIB cohort and a random date in the non-MDD cohort. Patients had continuous eligibility ≥12 months pre- and ≥1 month post-index. HRU and costs were compared during 1- and 12-month post-index periods between MDSI and control cohorts matched 1:1 on demographics. RESULTS The MDSI cohort included 73,242 patients (mean age 35 years, 60.6% female, 37.2% Medicaid coverage). At 1 month post-index, the MDSI cohort versus the MDD without SIB/non-MDD cohorts had 12.8/67.2 times more inpatient admissions and 3.3/8.9 times more emergency department visits; they had 2.9 times more outpatient visits versus the non-MDD cohort (all p < 0.001). The MDSI cohort had incremental mean healthcare costs of $5255 and $6674 per-patient-month versus the MDD without SIB and non-MDD cohorts (all p < 0.001); inpatient costs drove up to 89.5% of incremental costs. At 12 months post-index, HRU and costs remained higher in MDSI versus control cohorts. LIMITATIONS SIB are underreported in claims; unobserved confounders may cause bias. CONCLUSIONS MDSI is associated with substantial excess healthcare costs driven by inpatient costs, concentrated in the first month post-index, and persisting during the following year.
Collapse
|
7
|
Voelker J, Sheehan JJ, Le HH, Toro-Diaz H, Li S, Joshi K. US budget impact analysis of esketamine nasal spray in major depressive disorder with acute suicidal ideation/behavior. J Comp Eff Res 2022; 11:319-328. [DOI: 10.2217/cer-2021-0226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Esketamine nasal spray plus an oral antidepressant is approved in adults with major depressive disorder with acute suicidal ideation or behavior (MDSI). Methods: A budget impact analysis from a US payer perspective was performed with a hypothetical 1-million-member plan, using pharmacy and medical costs associated with adding esketamine plus an oral antidepressant to usual care. Results: Estimated annual total healthcare costs of managing patients with MDSI increased from $32,988,247 without esketamine to $34,161,188 in Year 3 with esketamine (primarily due to medical costs). The per-member-per-month incremental costs were $0.02, $0.06 and $0.10 in Years 1, 2 and 3, respectively. Conclusion: Incorporation of esketamine results in a modest estimated impact on the annual budget over a 3-year time horizon.
Collapse
Affiliation(s)
| | - John J Sheehan
- Janssen Scientific Affairs, LLC, Titusville, NJ 08560, USA
| | - Hoa H Le
- Janssen Scientific Affairs, LLC, Titusville, NJ 08560, USA
| | | | | | - Kruti Joshi
- Janssen Scientific Affairs, LLC, Titusville, NJ 08560, USA
| |
Collapse
|
8
|
Proudman D, Greenberg P, Nellesen D. The Growing Burden of Major Depressive Disorders (MDD): Implications for Researchers and Policy Makers. PHARMACOECONOMICS 2021; 39:619-625. [PMID: 34013439 PMCID: PMC8134814 DOI: 10.1007/s40273-021-01040-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2021] [Indexed: 05/14/2023]
|