Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population
**Background:** Essential tremor (ET), the most common movement disorder, often impairs patients’ ability to perform activities of daily living, mental health, and quality of life. **Objectives:** To assess comorbidities, psychiatric disorders, healthcare resource utilization (HCRU), and costs amon...
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Columbia Data Analytics, LLC
2022-08-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.37307 |
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| author | Dingwei Dai Ali Samiian Joaquim Fernandes Henriette Coetzer |
| author_facet | Dingwei Dai Ali Samiian Joaquim Fernandes Henriette Coetzer |
| author_sort | Dingwei Dai |
| collection | DOAJ |
| description | **Background:** Essential tremor (ET), the most common movement disorder, often impairs patients’ ability to perform activities of daily living, mental health, and quality of life.
**Objectives:** To assess comorbidities, psychiatric disorders, healthcare resource utilization (HCRU), and costs among patients with ET compared with patients without ET.
**Methods:** This retrospective observational study was conducted using a large US administrative claims database. Patients with ET were identified during the study period (1/1/2017–12/31/2019). The earliest claim date with ET diagnosis was identified as the index date. An index date was assigned randomly for each non-ET patient. Patients had to be at least 22 years old and be enrolled in the health plan for at least 6 months before and at least 12 months after the index date. Patients with and those without ET were matched 1:1 on age, gender, payer type, and first 3 digits of their ZIP code. Comorbidities were assessed using data within 6 months prior to the index date. Psychiatric disorders, HCRU, and costs were examined using data within 12 months after the index date.
**Results:** The mean (SD) age of ET patients (n = 5286) was 70.8 (11.8) years, 49.1% were female, and 82.9% were Medicare Advantage members. In the 12 months following the index date, 26.0% of patients had no insurance claims for ET-related pharmacotherapy or invasive therapies. Patients with ET had a higher number of comorbidities than non-ET patients (5.3 \[3.2\] vs 4.0 \[3.3\]); a higher prevalence of psychiatric disorders (depression: 25.6% vs 15.3%; adjusted odds ratio (AOR) \[95% CI\], 1.56 \[1.41-1.73\]; anxiety: 27.7% vs 15.5%, AOR: 1.78 \[1.61-1.96\]); and higher total healthcare costs: $17 560 \[$39 972\] vs $13 237 \[$27 098\], adjusted cost ratio \[95% CI\]: 1.11 \[1.06-1.16\]; all _P_<.0001.
**Discussion:** Highly prevalent multiple comorbidities and psychiatric disorders should be considered in the context of clinical decision-making to optimize ET management.
**Conclusions:** This study represents the largest observational study to report ET disease and economic burdens in a real-world setting. The data demonstrate increased comorbidity, mental health, and healthcare cost burdens among ET patients compared with matched non-ET patients. These findings underscore the need for innovative care for this complex population. |
| format | Article |
| id | doaj-art-046d3767e1694aeb850096a61ad50f27 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-046d3767e1694aeb850096a61ad50f272025-02-10T16:13:33ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362022-08-0192Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage PopulationDingwei DaiAli SamiianJoaquim FernandesHenriette Coetzer**Background:** Essential tremor (ET), the most common movement disorder, often impairs patients’ ability to perform activities of daily living, mental health, and quality of life. **Objectives:** To assess comorbidities, psychiatric disorders, healthcare resource utilization (HCRU), and costs among patients with ET compared with patients without ET. **Methods:** This retrospective observational study was conducted using a large US administrative claims database. Patients with ET were identified during the study period (1/1/2017–12/31/2019). The earliest claim date with ET diagnosis was identified as the index date. An index date was assigned randomly for each non-ET patient. Patients had to be at least 22 years old and be enrolled in the health plan for at least 6 months before and at least 12 months after the index date. Patients with and those without ET were matched 1:1 on age, gender, payer type, and first 3 digits of their ZIP code. Comorbidities were assessed using data within 6 months prior to the index date. Psychiatric disorders, HCRU, and costs were examined using data within 12 months after the index date. **Results:** The mean (SD) age of ET patients (n = 5286) was 70.8 (11.8) years, 49.1% were female, and 82.9% were Medicare Advantage members. In the 12 months following the index date, 26.0% of patients had no insurance claims for ET-related pharmacotherapy or invasive therapies. Patients with ET had a higher number of comorbidities than non-ET patients (5.3 \[3.2\] vs 4.0 \[3.3\]); a higher prevalence of psychiatric disorders (depression: 25.6% vs 15.3%; adjusted odds ratio (AOR) \[95% CI\], 1.56 \[1.41-1.73\]; anxiety: 27.7% vs 15.5%, AOR: 1.78 \[1.61-1.96\]); and higher total healthcare costs: $17 560 \[$39 972\] vs $13 237 \[$27 098\], adjusted cost ratio \[95% CI\]: 1.11 \[1.06-1.16\]; all _P_<.0001. **Discussion:** Highly prevalent multiple comorbidities and psychiatric disorders should be considered in the context of clinical decision-making to optimize ET management. **Conclusions:** This study represents the largest observational study to report ET disease and economic burdens in a real-world setting. The data demonstrate increased comorbidity, mental health, and healthcare cost burdens among ET patients compared with matched non-ET patients. These findings underscore the need for innovative care for this complex population.https://doi.org/10.36469/001c.37307 |
| spellingShingle | Dingwei Dai Ali Samiian Joaquim Fernandes Henriette Coetzer Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population Journal of Health Economics and Outcomes Research |
| title | Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population |
| title_full | Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population |
| title_fullStr | Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population |
| title_full_unstemmed | Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population |
| title_short | Multiple Comorbidities, Psychiatric Disorders, Healthcare Resource Utilization and Costs Among Adults with Essential Tremor: A Retrospective Observational Study in a Large US Commercially Insured and Medicare Advantage Population |
| title_sort | multiple comorbidities psychiatric disorders healthcare resource utilization and costs among adults with essential tremor a retrospective observational study in a large us commercially insured and medicare advantage population |
| url | https://doi.org/10.36469/001c.37307 |
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