(131) Depression among Newly Diagnosed Idiopathic Pulmonary Fibrosis (IPF) Patients before and during the COVID-19 Pandemic Era: a US-claims Based Analysis

Publication Number: 468

Background: Patients with idiopathic pulmonary fibrosis (IPF) have complex clinical journey, compounded by a higher risk of death from COVID-19. Additionally, increased isolation during the pandemic to avoid risk of infection may have impacted mental health.

Objectives: To examine depression and antidepressant (AD) treatment among newly diagnosed IPF patients before and during the COVID-19 pandemic in the US.

Methods: This retrospective analysis used IQVIA’s longitudinal prescription claims (LRx) linked to medical claims (Dx) (1MAR2017-28FEB2022). Patients newly diagnosed with IPF (indexed on first observed diagnosis) were placed into two mutually exclusive cohorts: pre-pandemic (1MAR2018-28FEB2019) and pandemic-era (1MAR2020-28FEB2021). All patients were ≥40 years of age, had ≥12 months of LRx-Dx data before (baseline) and after (follow-up) index, and ≥1 IPF diagnosis ≥30 days after index. During the 12-month follow-up, depression incidence and time to first depression diagnosis were examined among patients without baseline depression or evidence of AD treatment. AD treatment during follow-up was also examined among patients with prior depression diagnosis but no evidence of AD. Patient demographics, baseline comorbidities, and outcomes were compared between cohorts using Chi-square test for frequencies and Mann-Whitney test for medians.

Results: The pre-pandemic and pandemic-era cohorts included 6,808 and 5,082 patients, respectively. Cohorts had a similar median age (74.0 years) and were predominantly male (56.5-57.0%). At baseline, the pre-pandemic cohort had higher Charlson Comorbidity Index (median 2.0 vs. 1.0, p< 0.01) and consistently higher prevalence of comorbidities (e.g., respiratory/pulmonary: COPD, dyspnea, lower respiratory tract infection; other: cardiovascular disease, diabetes, dyslipidemia). The prevalence of baseline mental health disorders was similar between cohorts. Among patients without prior depression (pre-pandemic\pandemic-era; N=4,610\3,374), incidence during 12-month follow-up was similar between the cohorts (3.4-3.6%, p=0.59 ). Median (Q1-Q3) time to first depression diagnosis was numerically lower in the pandemic-era cohort (165.0 [63.0-266.0] vs. 188.0 [94.0-275.0] days, p=0.10). Among patients with baseline depression diagnosis but no prior AD (N=176\109), new AD claims during follow-up was similar between the cohorts (19.3-24.4%, p=0.31).

Conclusions: Depression incidence was similar within the first 12 months of IPF diagnosis, yet time to diagnosis was shorter among patients diagnosed in the pandemic-era. Further adjusted analysis are warranted to confirm these findings and the implications of capturing diagnoses in claims during the COVID-19 pandemic.