In “Antidepressant Discontinuation and Treatment-Emergent Sexual Dysfunction (TESD) among Patients with Major Depressive Disorder (MDD): A Hybrid Study Approach for Developing Real-World Evidence – Phase B Patient Survey”, funded by a pharmaceutical company sponsor, Carelon Research aimed to better understand the reasons why patients with major depressive disorder (MDD) continue to use, switch, or discontinue use of their AD medications, including the role that treatment-emergent sexual dysfunction (TESD) plays, from a patient-centered perspective.
This real-world, evidence-based study utilized a hybrid cohort design consisting of a cross-sectional internet survey of adult patients with MDD.
Respondents’ survey data were linked with their healthcare administrative claims data for the 12-month baseline period prior to and including the date of the survey to better understand AD use, including survey-based decisions to continue, switch, or discontinue AD medications.
Respondents were categorized as “Continuers,” “Switchers,” or “Discontinuers” based on their answers to the screening questions. Overall, 900 respondents completed the survey, including 554 (62%) continuers, 298 (33%) switchers, and 48 (5%) discontinuers.
Current and prior AD use and non-use, sexual dysfunction and TESD, drivers of AD switching, and healthcare resource utilization and costs were explored. Based on the patients’ perspectives, we found that healthcare provider recommendations, treatment efficacy, and medication side effects all play an important role in AD continuation, switching, and discontinuation of treatments for MDD.
Major reasons patients gave for switching or discontinuing use of prior ADs were related to treatment satisfaction, efficacy, and the occurrence of side effects. For continuers and switchers, sexual problems were commonly reported, yet often were not discussed with a healthcare provider. Continuers reported the highest rate of sexual dysfunction, while also reporting the lowest severity of depressive symptoms, potentially indicating a willingness to tolerate long-term side effects in exchange for efficacy in this population.
These findings may inform the importance of patient-physician shared decision-making for MDD management, with the goal of minimizing side effects while maintaining treatment effect.
Findings from this study were presented at ASCP 2022. Registration is required.