Introduction
Methods
Patient Population and Data Collection
Statistical Analysis
Results
Characteristics | Before matching | After matching | ||||||
---|---|---|---|---|---|---|---|---|
All | RA/depression | RA only | Standardized difference | All | RA/depression | RA only | Standardized difference | |
N = 7311 | N = 473 | N = 6838 | N = 2270 | N = 454 | N = 1816 | |||
Gender | ||||||||
Female | 5391 (73.74%) | 375 (79.28%) | 5016 (73.35%) | 0.14121* | 1799 (79.25%) | 358 (78.85%) | 1441 (79.35%) | − 0.01219 |
Male | 1920 (26.26%) | 98 (20.72%) | 1822 (26.65%) | 471 (20.75%) | 96 (21.15%) | 375 (20.65%) | ||
Age at index-date | ||||||||
Mean (Sd) | 51.93 (10.94) | 52.55 (10.72) | 51.89 (10.95) | 0.06128 | 52.64 (10.91) | 52.41 (10.68) | 52.70 (10.97) | − 0.02664 |
Min–Max | [18.0; 75.0] | [21.0; 75.0] | [18.0; 75.0] | [18.0; 75.0] | [21.0; 75.0] | [18.0; 75.0] | ||
Median | 53 | 53 | 53 | 54 | 53 | 54 | ||
Q1–Q3 | [44.0; 60.0] | [46.0; 60.0] | [44.0; 60.0] | [45.0; 60.0] | [46.0; 60.0] | [45.0; 60.0] | ||
Calendar year of index date | ||||||||
2010 | 1471 (20.12%) | 59 (12.47%) | 1412 (20.65%) | 0.36993* | 277 (12.20%) | 59 (13.00%) | 218 (12.00%) | 0.04186 |
2011 | 716 (9.79%) | 46 (9.73%) | 670 (9.80%) | 232 (10.22%) | 46 (10.13%) | 186 (10.24%) | ||
2012 | 728 (9.96%) | 56 (11.84%) | 672 (9.83%) | 268 (11.81%) | 53 (11.67%) | 215 (11.84%) | ||
2013 | 2739 (37.46%) | 147 (31.08%) | 2592 (37.91%) | 720 (31.72%) | 147 (32.38%) | 573 (31.55%) | ||
2014 | 1001 (13.69%) | 82 (17.34%) | 919 (13.44%) | 403 (17.75%) | 78 (17.18%) | 325 (17.90%) | ||
2015 | 656 (8.97%) | 83 (17.55%) | 573 (8.38%) | 370 (16.30%) | 71 (15.64%) | 299 (16.46%) | ||
Follow-up duration in months | ||||||||
Mean (Sd) | 31.08 (19.23) | 27.37 (18.97) | 31.34 (19.22) | 0.08418 | 27.69 (18.35) | 28.07 (18.92) | 27.59 (18.21) | 0.01201 |
Min–Max | [1.0; 71.0] | [1.0; 71.0] | [1.0; 68.0] | [1.0; 71.0] | [1.0; 71.0] | [1.0; 68.0] | ||
Median | 29 | 27 | 29 | 28 | 27 | 28 | ||
Q1–Q3 | [17.0; 42.0] | [11.0; 37.0] | [17.0; 43.0] | [13.0; 38.0] | [12.0; 38.0] | [13.0; 39.0] | ||
Charlson comorbidity index (CCI) | ||||||||
Mean (Sd) | 2.08 (1.77) | 2.25 (2.42) | 2.07 (1.71) | − 0.20821* | 2.12 (1.84) | 2.14 (2.28) | 2.12 (1.71) | 0.02562 |
Min–Max | [0.0; 19.0] | [0.0; 16.0] | [1.0; 19.0] | [0.0; 15.0] | [0.0; 12.0] | [1.0; 15.0] | ||
Median | 1 | 2 | 1 | 1 | 2 | 1 | ||
Q1–Q3 | [1.0; 3.0] | [1.0; 3.0] | [1.0; 3.0] | [1.0; 3.0] | [0.0; 3.0] | [1.0; 3.0] | ||
Renal failure | ||||||||
Yes | 97 (1.33%) | 12 (2.54%) | 85 (1.24%) | 0.09513 | 41 (1.81%) | 8 (1.76%) | 33 (1.82%) | − 0.00415 |
No | 7214 (98.67%) | 461 (97.46%) | 6753 (98.76%) | 2229 (98.19%) | 446 (98.24%) | 1783 (98.18%) | ||
Interstitial pneumonia | ||||||||
Yes | 167 (2.28%) | 10 (2.11%) | 157 (2.30%) | − 0.01238 | 48 (2.11%) | 10 (2.20%) | 38 (2.09%) | 0.0076 |
No | 7144 (97.72%) | 463 (97.89%) | 6681 (97.70%) | 2222 (97.89%) | 444 (97.80%) | 1778 (97.91%) | ||
COPD | ||||||||
Yes | 665 (9.10%) | 73 (15.43%) | 592 (8.66%) | 0.20931* | 315 (13.88%) | 59 (13.00%) | 256 (14.10%) | − 0.03219 |
No | 6646 (90.90%) | 400 (84.57%) | 6246 (91.34%) | 1955 (86.12%) | 395 (87.00%) | 1560 (85.90%) | ||
Peptic ulcer | ||||||||
Yes | 14 (0.19%) | 1 (0.21%) | 13 (0.19%) | 0.00476 | 3 (0.13%) | 1 (0.22%) | 2 (0.11%) | 0.02712 |
No | 7297 (99.81%) | 472 (99.79%) | 6825 (99.81%) | 2267 (99.87%) | 453 (99.78%) | 1814 (99.89%) | ||
Chronic liver disease | ||||||||
Yes | 68 (0.93%) | 4 (0.85%) | 64 (0.94%) | − 0.00961 | 19 (0.84%) | 4 (0.88%) | 15 (0.83%) | 0.00599 |
No | 7243 (99.07%) | 469 (99.15%) | 6774 (99.06%) | 2251 (99.16%) | 450 (99.12%) | 1801 (99.17%) | ||
Osteoporosis | ||||||||
Yes | 2000 (27.36%) | 145 (30.66%) | 1855 (27.13%) | 0.07789 | 656 (28.90%) | 133 (29.30%) | 523 (28.80%) | 0.01092 |
No | 5311 (72.64%) | 328 (69.34%) | 4983 (72.87%) | 1614 (71.10%) | 321 (70.70%) | 1293 (71.20%) | ||
Diabetes | ||||||||
Yes | 1965 (26.88%) | 122 (25.79%) | 1843 (26.95%) | 0.03853 | 540 (23.79%) | 114 (25.11%) | 426 (23.46%) | 0.03853 |
No | 5346 (73.12%) | 351 (74.21%) | 4995 (73.05%) | 1730 (76.21%) | 340 (74.89%) | 1390 (76.54%) |
6 months | 12 months | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
RA/depression | RA only | P value | Attributable to depression (difference) | Ratio (SE) | RA/depression | RA only | P value | Attributable to depression (difference) | Ratio (SE) | |
Number of patients | N = 454 | N = 1816 | N = 454 | N = 1816 | ||||||
Total outpatient visits | ||||||||||
N (%)* | 454 (100%) | 1795 (99%) | 0.639 | – | – | 454 (100%) | 1805 (99%) | 0.3263 | – | – |
Mean (SE)# | 3.073 (0.035) | 1.899 (0.014) | < 0.0001 | + 1.174 | 1.618 (0.01) | 2.688 (0.024) | 1.728 (0.009) | < 0.0001 | + 0.96 | 1.556 (0.010) |
Psychiatric visits | ||||||||||
N (%)* | 252 (55%) | 34 (2%) | < 0.0001 | – | – | 258 (57%) | 38 (2%) | < 0.0001 | – | – |
Mean (SE)# | 1.277 (0.030) | 0.887 (0.067) | < 0.0001 | + 0.39 | 1.439 (0.08) | 1.041 (0.020) | 0.700 (0.042) | < 0.0001 | + 0.341 | 1.487 (0.062) |
Non-psychiatric visits | ||||||||||
N (%)* | 448 (99%) | 1795 (99%) | 0.7532 | – | – | 449 (99%) | 1805 (99%) | 0.5951 | – | – |
Mean (SE)# | 2.525 (0.031) | 1.886 (0.014) | < 0.0001 | + 0.639 | 1.339 (0.01) | 2.216 (0.022) | 1.716 (0.009) | < 0.0001 | + 0.5 | 1.291 (0.011) |
Hospitalizations | ||||||||||
N (%)* | 64 (14%) | 128 (7%) | < 0.0001 | – | – | 86 (19%) | 168 (9%) | < 0.0001 | – | – |
Mean (SE)# | 0.224 (0.025) | 0.228 (0.018) | 0.881 | − 0.004 | 0.98 (0.136) | 0.126 (0.012) | 0.138 (0.009) | 0.419 | − 0.012 | 0.913 (0.113) |
Emergency visit | ||||||||||
N (%)* | 9 (2%) | 26 (1%) | 0.4001 | – | – | 14 (3%) | 34 (2%) | 0.096 | – | – |
Mean (SE)# | 1.960 (0.198) | 1.183 (0.088) | < 0.0001 | + 0.777 | 1.66 (0.125) | 1.685 (0.106) | 0.640 (0.041) | < 0.0001 | + 1.045 | 2.633 (0.090) |
6 months | 12 months | |||||
---|---|---|---|---|---|---|
Hazard ratio | 95% CI | P value | Hazard ratio | 95% CI | P value | |
Number of patients | N = 454 | N = 1816 | N = 454 | N = 1816 | ||
Total outpatient visits | ||||||
RA only | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA/depression | 1.45 | [1.305; 1.610] | < 0.0001 | 1.465 | [1.319; 1.628] | < 0.0001 |
Psychiatric visits | ||||||
RA only | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA/depression | 3.973 | [2.599; 6.075] | < 0.0001 | 3.268 | [2.234; 4.780] | < 0.0001 |
Non-psychiatric visits | ||||||
RA only | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA/depression | 1.239 | [1.116; 1.375] | < 0.0001 | 1.257 | [1.133; 1.395] | < 0.0001 |
Hospitalizations | ||||||
RA only | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA/depression | 1.474 | [1.053; 2.062] | 0.0236 | 1.064 | [0.802; 1.411] | 0.6683 |
Emergency visit | ||||||
RA only | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA/depression | 2.059 | [1.602; 2.646] | < 0.0001 | 4.189 | [3.508; 5.003] | < 0.0001 |
6 months | 12 months | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
RA/depression, N = 454 | RA only, N = 1816 | P value | Attributable to depression (difference) | Rate ratio (SE) | RA/depression, N = 454 | RA only, N = 1816 | P value | Attributable to depression (difference) | Rate ratio (SE) | |
Out-patient costs | 531,55 (4.541) | 37735 (1.908) | < 0.0001 | 15,420 | 1.409 (0.000) | 48,620 (3.188) | 35,885 (1.362) | < 0.0001 | 12,735 | 1.355 (0.000) |
In-patient costs | 30,285 (3.427) | 18,603 (1.340) | < 0.0001 | 11,682 | 1.628 (0.000) | 23,445 (2.214) | 15,441 (0.894) | < 0.0001 | 8004 | 1.518 (0.000) |
Pharmacy costs | 32,628 (3.558) | 19,611 (1.376) | < 0.0001 | 13,017 | 1.664 (0.000) | 30,035 (2.506) | 18,594 (0.981) | < 0.0001 | 11,441 | 1.615 (0.000) |
Total costs | 116,068 (6.710) | 76,362 (2.722) | < 0.0001 | 39,706 | 1.528 (0.000) | 102,101 (4.620) | 70,079 (1.906) | < 0.0001 | 32,022 | 1.460 (0.000) |
Depression status | 6 months | 12 months | Follow-up period | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P value | Estimate | 95% CI | P value | Estimate | 95% CI | P value | ||
Total out-patient costs | No RA | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA | 1.713 | [1.713; 1.714] | < 0.0001 | 1.833 | [1.832; 1.833] | < 0.0001 | 1.932 | [1.931; 1.932] | < 0.0001 | |
Total in-patient costs | No RA | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA | 1.395 | [1.395; 1.395] | < 0.0001 | 1.332 | [1.331; 1.332] | < 0.0001 | 1.47 | [1.470; 1.471] | < 0.0001 | |
Pharmacy costs | No RA | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA | 2.003 | [2.003; 2.004] | < 0.0001 | 2.055 | [2.054; 2.055] | < 0.0001 | 2.284 | [2.283; 2.284] | < 0.0001 | |
Total medical costs | No RA | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
RA | 1.645 | [1.645; 1.645] | < 0.0001 | 1.701 | [1.700; 1.701] | < 0.0001 | 1.869 | [1.869; 1.869] | < 0.0001 |