Abstract: TH-PO723
Sex and Racial Disparities in Antidepressant Use and Hospitalization Rates Among Patients on Hemodialysis
Session Information
- Women's Health and Kidney Diseases
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women’s Health and Kidney Diseases
- 2000 Women’s Health and Kidney Diseases
Authors
- Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Willetts, Joanna, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Kim, Billy, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Dugan, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Eneanya, Nwamaka D., University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Ketchersid, Terry L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
Women are more affected by depression than men in the general population (Kimmel et al., 2007). We characterized if there were differences by sex and race in depressive affect (DA), antidepressant use, and hospitalization rates in hemodialysis (HD) patients.
Methods
We analyzed data of patients on HD treated during 2016 to 2017. We studied patients who completed DA screening via the patient health questionnaire-2 (PHQ2) and the Center for Epidemiologic Studies Depression Scale (CES-D-10). Those with PHQ2≥3 were further screened using the CES-D-10. Patients scoring ≥10 on the CES-D-10 or those with a prior diagnosis of depression or bipolar disorder were classified DA positive; screened patients with PHQ2<3 were classified DA negative. Analyses were stratified by DA status, antidepressant use, sex and race. We compared hospitalization rates between groups.
Results
In a population of 267,955 HD patients, A higher percent of women screened positive for DA when compared to men (6.5% vs 4.4%, respectively). Black women had less DA than white women (5.4% vs 7.5%). Antidepressants use by DA positive white women was 5.4% vs 3% for DA positive black women; DA negative white women had a higher use of antidepressants when compared to DA-negative black women (3% vs 2.3%, respectively). Similar findings were observed for men. Twenty-eight percent of patients were using an antidepressant; of those, 51.5% were women. White women had higher antidepressant use (36.7%), followed by white men (25.8%), black women (23.4%), and black men (15.9%). Hospitalization rates were higher for women than for men irrespective of depressive symptoms, antidepressant use or race (p<0.0001), and antidepressant use was associated with higher hospitalization rates when compared to non-users (women: 2.3 vs 1.6 per patient year (ppy, p<0.0001); men: 2.2 vs 1.4 ppy (p<0.0001)). Black women on antidepressants had higher hospitalization rates than white women (2.51 vs 2.27 ppy, p<0.0001).
Conclusion
We identified that women, particularly of black race taking antidepressants, have higher hospitalization rates when compared to those not taking any medication, irrespective of their current DA status. Future studies can elucidate reasons for these disparities in outcomes.
Funding
- Commercial Support –