ABSTRACT
Objectives: Postpartum depression (PPD) has been described as "the thief that steals motherhood" by depriving women of the anticipated joy of a new infant. Through this study, we intend to see the incidence, treatment rates (TR), relative-treatment rate (TRR), absolute treatment rate (ATR), and number needed to treat (NNT) pre- and post-COVID-19 on treatment of women with PPD. Method(s): This retrospective cohort study included newly diagnosed patients with PPD in 2019 (1st Jan - 31st Dec [pre-pandemic]) and 2020 (1st Jan - 31st Dec [pandemic]) using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart. Only the patients having continuous eligibility between 12 months before (baseline period) to 12-months post (follow-up period) the first diagnosis of PPD (index date) were included in study. During the follow-up period, patients were then checked for pharmacological treatment received (SSRI, SNRI's and other anti-depressants) using NDC codes. To measure effects, percentages of patients getting treatment, TRR (TR in pandemic/TR in pre-pandemic), ATR (TR in pre-pandemic - TR in a pandemic), and NNT (1/ATR) were calculated before and during COVID. The significance of categorical variables was examined using the Chi-square test. Result(s): We observed 39% increase in incidence of PPD patients during pandemic (n=16,095) vs pre-pandemic (n=11,565). Only 51% TR (risk ratio) was observed during pandemic vs 60% TR (risk ratio) in pre-pandemic with any SSRI, SNRI, and anti-depressants (p<.01). Compared to patients receiving treatment during pandemic vs pre-pandemic: TRR was found to be 85% (relative risk) and ATR was 9% (absolute risk reduction). The NNT comparing pre- and during pandemic was 11. Conclusion(s): The results of the study demonstrated that treatment of women with PPD was impacted during pandemic vs pre-pandemic (9% women did not receive treatment during pandemic). Alternative methods or non-pharmacological treatments may be required to further alleviate non-treated patients and improve their condition. Copyright © 2022
ABSTRACT
Objectives: This study aimed to explore the impact of COVID-19 on patients with PTSD and the burden of resource utilization in the pre- and during the COVID-19 pandemic. Method(s): This retrospective observational study included patients diagnosed with PTSD between 1st January 2018 to 31st December 2020 using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart database. In the study duration, distinct patients were identified and further classified by age, gender, and location of service. To determine the influence in pre- and during COVID-19 for each of the stratification variables, a year-wise comparison was done. Chi-square was performed as test of significance for categorical variables. Result(s): Overall we observed the number of PTSD patients increased by 7% (n=206,741) during the pandemic (1st January 2020 - 31st December 2020) vs pre-pandemic (1st January 2019 - 31st December 2019). A significant increase was seen across all age groups (p<.05). In the case of teenagers, PTSD was found to have increased by 22% whereas in adults and the elderly an 8% and 3% increase was seen respectively. When broken down by gender, a significant increase was observed. Females (+9% [n=143,032]) were seen to have been affected more compared to males (+4% [n=63,625]) during the pandemic vs pre-pandemic. In healthcare resources utilization overall, there was an observed 24% increase. For both inpatients and office, PTSD decreased significantly (-3% and -4% respectively) (p<.05);while ER visits, increased only by 1% (p<.05). A significant increase in outpatient and telehealth services was observed (122% and 454% respectively) (p<.05). Conclusion(s): An increased exacerbation in PTSD was observed during the pandemic with respect to burden across various stratification and resource utilization;especially in outpatient and telehealth services. Better treatment, psychotherapy and alternative care programs may be required to curb this impact and decrease the overall burden across various care setting. Copyright © 2022
ABSTRACT
Objectives: This study aimed to explore the impact of COVID-19 on patients with SSA and the burden of resource utilization in the pre- and during the COVID-19 pandemic. Method(s): This retrospective observational study included patients diagnosed with SSA between 1st January 2019 to 31st December 2020 using ICD-10-CM codes from Optum's de-identified Clinformatics Data Mart. In the study duration, distinct patients were identified and further classified by age, gender, and location of service. To determine the influence in pre- and during COVID-19 for each of the stratification variables, a year-wise comparison was done. Chi-square test was performed to check the significance of categorical variables. Result(s): Overall we observed the number of SSA patients increased by 2% (n=266,329) during the pandemic (1st January 2020 - 31st December 2020). A significant increase was seen across all age groups (p<.01). In the case of teenagers, SSA was found to have increased by 80% whereas in adults and elderly an 15% and 8% increase was seen respectively during pandemic (p<.01). When stratified by gender, a significant increase was observed only in females (+9% [n=174,647]) where in males (-3% [n=91,573]) decrease was observed during pandemic. In healthcare resources utilization overall, there was an observed 12% increase during pandemic. For inpatients, office, and outpatient, SSA decreased significantly (-4%, -8%, and -1% respectively) during pandemic (p<.01). A significant increase in outpatient and telehealth services was observed (34% and 1,299% respectively) (p<.01). Conclusion(s): An increased exacerbation in SSA was observed during the pandemic with telehealth and outpatient services being impacted the highest. This may be attributed to facing near-death scenarios, and the loss of loved ones amongst other factors. With the increase in cases, health care resource utilization across various settings is pressed. Better treatment and programs may be required to curb this impact and decrease the overall burden. Copyright © 2022
ABSTRACT
Objectives: This study examines use of telemedicine services and health outcomes in patients with hypertension (HTN) in pre- and post-COVID 19 periods in the US. Method(s): A retrospective analysis, using Optum de-identified Electronic Health Record dataset, was done among hypertensive patients on Medicare plans in three different time periods: 1st Jan 2018 - 30th June 2018, 1st Jan - 30th June 2019, and 1st Jan - 30th June 2020 (first two time periods are pre-COVID 19 and the last one is post-COVID 19). The date of first EHR with mention of HTN diagnosis was considered index date. Study participants were categorized into those who used only telemedicine services (Telemedicine group);only other places of service like outpatient, inpatient, or office (Other POS group);and those who used both telemedicine and other places of service (Both POS groups). Patients were followed for 6-months post-index to determine use of anti-HTN medications, resource utilization, and healthcare outcomes. Result(s): Fewer than 100 patients in each study period belonged to Telemedicine group. Majority (55%) patients in 2018 (pre-COVID 19) belonged to Other POS group, but in 2020 (post-COVID 19) majority (61%) patients belonged to Both POS group. About 70% patients in each of three groups were prescribed anti-HTN drugs and adherence was >90%. About ~60% patients in Telemedicine group had 2-6 healthcare encounters while ~80% in Other POS group and ~95% in Both POS groups had >6 healthcare encounters during follow-up period. Significantly more patients in Both POS groups received anti-HTN nutritional counseling as compared to other two groups. Also, blood pressure was controlled in significantly higher percentage of patients in Both POS groups as compared to other two groups. Conclusion(s): Patients who use telemedicine and other places of service are more likely to receive anti-HTN nutritional counseling and have better blood pressure control. Copyright © 2022