Impact of psychiatric comorbidities on health care utilization and cost of care in multiple myeloma

Shehzad Niazi, Ryan D. Frank, Mayank Sharma, Vivek Roy, Steve Ames, Teresa Rummans, Aaron Spaulding, Taimur Sher, Meghna Ailawadhi, Kirtipal Bhatia, Salman Ahmed, Winston Tan, Asher A Chanan Khan, Sikander Ailawadhi

Research output: Contribution to journalArticle

Abstract

Approximately one third of cancer patients suffer from comorbid mood disorders that are associated with increased cost and poorer outcomes. The majority of patients with multiple myeloma (MM) are treated with corticosteroids; as many as three fourths of those taking corticosteroids develop neuropsychiatric complications, likely increasing morbidity and cost of care. MM patients diagnosed between 1991 and 2010 and reported in the Surveillance Epidemiology, and End Results-Medicare database were characterized as MM-Only, MM+Psychiatric (any psychiatric condition, preexisting or post-MM), or MM+Depression (depression as the only psychiatric diagnosis, preexisting or post-MM). Differences in demographic characteristics, occurrence of clinical myeloma-defining events (MDEs), health care utilization (inpatient, outpatient, ambulatory claims), and cost of care during the first 6 months of MM diagnosis were analyzed. Psychiatric comorbidities were reported more frequently in females, and racial minorities had lower rates of psychiatric comorbidities. All clinical MDEs were more common in the MM+Psychiatric and MM+Depression groups; within them, the majority were more common in patients diagnosed with the psychiatric condition or depression after MM compared with it being a preexisting condition. Health care utilization in all treatment settings was higher in those with psychiatric comorbidities. Cost of care within the first 6 months after MM diagnosis was significantly higher in the MM+Psychiatric and MM+Depression groups. This increase in cost was more pronounced for patients from racial minorities diagnosed with a psychiatric condition, including depression. Psychiatric comorbidities significantly impact the clinical presentations, health care utilization, and cost among patients with MM. These findings need to be addressed for improved survivorship of MM patients.

Original languageEnglish (US)
Pages (from-to)1120-1128
Number of pages9
JournalBlood advances
Volume2
Issue number10
DOIs
StatePublished - May 22 2018

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Patient Acceptance of Health Care
Multiple Myeloma
Health Care Costs
Psychiatry
Comorbidity
Depression
Costs and Cost Analysis
Preexisting Condition Coverage
Adrenal Cortex Hormones

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Impact of psychiatric comorbidities on health care utilization and cost of care in multiple myeloma. / Niazi, Shehzad; Frank, Ryan D.; Sharma, Mayank; Roy, Vivek; Ames, Steve; Rummans, Teresa; Spaulding, Aaron; Sher, Taimur; Ailawadhi, Meghna; Bhatia, Kirtipal; Ahmed, Salman; Tan, Winston; Chanan Khan, Asher A; Ailawadhi, Sikander.

In: Blood advances, Vol. 2, No. 10, 22.05.2018, p. 1120-1128.

Research output: Contribution to journalArticle

Niazi, Shehzad ; Frank, Ryan D. ; Sharma, Mayank ; Roy, Vivek ; Ames, Steve ; Rummans, Teresa ; Spaulding, Aaron ; Sher, Taimur ; Ailawadhi, Meghna ; Bhatia, Kirtipal ; Ahmed, Salman ; Tan, Winston ; Chanan Khan, Asher A ; Ailawadhi, Sikander. / Impact of psychiatric comorbidities on health care utilization and cost of care in multiple myeloma. In: Blood advances. 2018 ; Vol. 2, No. 10. pp. 1120-1128.
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AU - Ames, Steve

AU - Rummans, Teresa

AU - Spaulding, Aaron

AU - Sher, Taimur

AU - Ailawadhi, Meghna

AU - Bhatia, Kirtipal

AU - Ahmed, Salman

AU - Tan, Winston

AU - Chanan Khan, Asher A

AU - Ailawadhi, Sikander

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AB - Approximately one third of cancer patients suffer from comorbid mood disorders that are associated with increased cost and poorer outcomes. The majority of patients with multiple myeloma (MM) are treated with corticosteroids; as many as three fourths of those taking corticosteroids develop neuropsychiatric complications, likely increasing morbidity and cost of care. MM patients diagnosed between 1991 and 2010 and reported in the Surveillance Epidemiology, and End Results-Medicare database were characterized as MM-Only, MM+Psychiatric (any psychiatric condition, preexisting or post-MM), or MM+Depression (depression as the only psychiatric diagnosis, preexisting or post-MM). Differences in demographic characteristics, occurrence of clinical myeloma-defining events (MDEs), health care utilization (inpatient, outpatient, ambulatory claims), and cost of care during the first 6 months of MM diagnosis were analyzed. Psychiatric comorbidities were reported more frequently in females, and racial minorities had lower rates of psychiatric comorbidities. All clinical MDEs were more common in the MM+Psychiatric and MM+Depression groups; within them, the majority were more common in patients diagnosed with the psychiatric condition or depression after MM compared with it being a preexisting condition. Health care utilization in all treatment settings was higher in those with psychiatric comorbidities. Cost of care within the first 6 months after MM diagnosis was significantly higher in the MM+Psychiatric and MM+Depression groups. This increase in cost was more pronounced for patients from racial minorities diagnosed with a psychiatric condition, including depression. Psychiatric comorbidities significantly impact the clinical presentations, health care utilization, and cost among patients with MM. These findings need to be addressed for improved survivorship of MM patients.

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