Saturday, June 22, 2024

Impact of Psychiatric Comorbidities on Health Care Utilization and Costs in Adults with ADHD

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A recent study sheds light on the significant clinical and economic impact of psychiatric comorbidities in adults diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). The research focuses on how anxiety and depression, common comorbid conditions, influence health care resource utilization (HRU) and associated costs. This study provides insights into the necessity for targeted management strategies to alleviate the overall burden on patients and the health care system.

Study Design and Methods

Conducted retrospectively, the study utilized data from the IQVIA PharMetrics Plus database covering October 2015 to September 2021. Researchers identified adults diagnosed with ADHD and categorized them based on the presence or absence of anxiety and/or depression. The index date was determined by the initiation of ADHD treatment, with a 6-month baseline period preceding it and a 12-month study period following it. Entropy balancing was employed to ensure comparable baseline characteristics between the two groups, facilitating accurate analysis of HRU and cost differentials.

Key Findings

The results revealed that adults with ADHD and comorbid anxiety and/or depression exhibited significantly higher HRU across various domains compared to those with ADHD alone. Specifically, the incidence rate ratios for inpatient admissions, emergency department visits, outpatient visits, and psychotherapy sessions were markedly higher. Additionally, the study highlighted that the mean per-patient per-year health care costs for individuals with both ADHD and psychiatric comorbidities were more than twice as high as those for patients with only ADHD.

Patients were further stratified into subgroups based on the type of comorbidity. Those with both anxiety and depression incurred the highest costs, followed by those with only depression, and lastly, those with only anxiety. These findings underscore the compounded burden faced by patients dealing with multiple psychiatric conditions alongside ADHD.

Actionable Insights for Health Care Providers

  • Integrated management of ADHD and psychiatric comorbidities can significantly reduce health care resource utilization and costs.
  • Prioritizing mental health interventions for patients with ADHD, especially those with anxiety and depression, is crucial.
  • Health care systems should adopt comprehensive care plans that address both ADHD and its psychiatric comorbidities to alleviate patient burden.

Overall, the study highlights the critical need for integrated care models that address both ADHD and its associated psychiatric comorbidities. By focusing on comprehensive management, health care providers can potentially alleviate the substantial clinical and economic burdens faced by these patients.

Original Article: J Manag Care Spec Pharm. 2024 Jun;30(6):588-598. doi: 10.18553/jmcp.2024.30.6.588.

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