Observational study to characterize treatment-resistant depression in Germany, France and the United Kingdom: analysis of real-world data collected through a survey of healthcare professionals

Abstract

Objective

This study describes treatment patterns, productivity, healthcare resource utilization and previous episodes of depression for patients with treatment-resistant depression (TRD).

Methods

In this cross-sectional study, a quantitative survey was administered to 225 healthcare providers (HCPs) distributed evenly across Germany, France and the UK from July to August 2021. Each HCP was asked to answer based on medical records of five patients with TRD, defined as patients failing to respond to two or more treatments of adequate dose and duration in the same episode of major depressive disorder (MDD), which provided a sample size of 1125 patients.

Results

Of the 1125 patients with TRD, 73.2% had two or more previous episodes of MDD, 46.3% had a history of suicidal ideation and 24.8% had attempted suicide. Only 26.8% of patients were employed either full-time or part-time. During the most recent/current TRD episode, 45.5% of patients received five or more lines of treatment, and 46.0% remained on monotherapy. For multiple pharmacological treatments, too many distinct combinations were used to discern trends. Overall, 60.6% of patients had at least one mental health-related hospitalization in the last 12 months; 35.0% had two or more hospitalizations. Half of TRD patients saw a doctor five or more times per year for their depression.

Conclusions

This study addresses the knowledge gap about treatment patterns and healthcare utilization in real-world practice for TRD patients in three European countries. It provides data that potentially could inform treatment guideline development and optimize patient-perceived benefits from the treatment of TRD.

Keywords:

• Treatment-resistant depression
• real-world data
• treatment patterns
• patient record forms
• mental healthcare professionals
• mental health

Transparency

Declaration of funding

The study was funded by COMPASS Pathways PLC, London, United Kingdom.

Declaration of financial/other relationships

L.S.O., L.M., M.T.M. and S.P.L. have disclosed that they are employees of COMPASS Pathways PLC and hold stocks in the company. S.J.O. has disclosed that he is a consultant who works with COMPASS on several projects and holds stocks in the company. A.S.P., M.N.B. and X.D. have disclosed that they are employees of ICON PLC and received funding from COMPASS to conduct the study.

A reviewer on this manuscript disclosed that they have received manuscript or speaker’s fees from Astellas, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Elsevier Japan, Janssen Pharmaceuticals, Kyowa Yakuhin, Lundbeck Japan, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Nihon Medi-Physics, Novartis, Otsuka Pharmaceutical, Shionogi, Shire, Takeda Pharmaceutical, Tsumura, Wiley Japan and Yoshitomi Yakuhin, and research grants from Dainippon Sumitomo Pharma, Eisai, Mochida Pharmaceutical, Meiji Seika Pharma and Shionogi. CMRO peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the conception and design of the study and to the interpretation of the findings. A.S.P., M.N.B. and X.D. performed the analysis. All authors reviewed and approved the final version of the manuscript.

Acknowledgements

The authors thank Mr. Daniel Sutcliffe (COMPASS pathways PLC) for assistance during protocol development.

Data availability statement

Raw data used to draw the conclusions of this study are available as a supplementary file.

Ethical approval

This was a non-interventional, retrospective analysis based on data collected in clinical practice, so institutional review board approval and informed consent were not required. Patient identifiers are not disclosed and only summary data are presented.