Post-partum depression (PPD) is a serious public health problem, and proper management of the disease is warranted for the well-being of both the mother and the child. PPD is a type of depressive disorder, which occurs within the first month after childbirth. PPD has a profound impact on maternal health and wellbeing, with both short-term and long-term implications for the developing child and wider family. Unfortunately, about 50% of the PPD cases are under-reported even though they are at higher risk for psychiatric disorders. Thus, PPD may result in increased use of national health services and associated cost. There is limited evidence showing health service use in women with PPD using data from different countries. Therefore, this study focuses on comparing use and associated cost of health services, associated conditions, and patterns of treatment among women with and without PPD in the UK using the Clinical Practice Research Datalink (CPRD) research database.
This matched cohort study will use data from the UK Clinical Practice Research Datalink (CPRD), MHRA Pregnancy Registry, Hospital Episode Statistics (HES), and ONS Mortality data from 2009 to 2014 to determine the disease burden of PPD and associated treatment patterns in a real-world clinical setting. The aim of the study is to compare outcomes in patients with PPD versus non-PPD patients. The linked data sets have been selected to enable the estimation of resource utilization and cost, but may also enable better case definitions for the target population and provide a more clearly defined exposure window for depression. The study cohort will consist of women aged 15 to 50 years, that during the study period, had at least one live birth but no stillbirths, and no history of major depressive disorders or prescriptions for antipsychotic medications in the 12 months prior to delivery. The matching of PPD cases to non-PPD controls will be performed, at a 1:1 ratio, using multivariate Propensity Score Matching techniques. Primary outcomes will include health care resource utilization, cost, and comorbidities. Secondary outcomes include treatment adherence, switching, and discontinuation. The comparison of these outcomes, between cases and controls, will be analyzed using appropriate descriptive statistical methodologies.
Health Care Costs; Comorbidities; Health Care Resource Utilization; Clinical Outcomes (e.g., suicidal ideation or behavior); Adherence & Persistence of Antidepressant Treatment.
Christian Bannister - Chief Investigator - Digital Health Labs Limited
Christian Bannister - Corresponding Applicant - Digital Health Labs Limited
Debra D'Angelo - Collaborator - STATinMED Research
Onur Baser - Collaborator - STATinMED Research
HES Accident and Emergency;HES Accident and Emergency;HES Admitted Patient Care;HES Admitted Patient Care;HES Outpatient;HES Outpatient;ONS Death Registration Data;ONS Death Registration Data;Pregnancy Register;Pregnancy Register