Real-world evidence from a European cohort study of patients with treatment resistant depression: Country-specific data for Portugal

Abstract

Background

Treatment resistant depression (TRD; failure to respond to ≥2 treatments in the same major depressive episode) affects 10–30 % of patients with major depressive disorder. In Portugal, the disease burden is estimated to exceed that of heart failure, highlighting the critical unmet needs of these patients.

Methods

A non-interventional cohort study of patients with TRD collected real-world data from several European countries. All patients started a new antidepressant treatment at baseline. We present a sub-analysis of baseline characteristics and Month 6 treatment outcomes in Portuguese patients.

Results

Among 411 patients enrolled, 37 were Portuguese. At baseline, 45.9 % of Portuguese patients had severe depression versus 32.6 % of the total study population. Portuguese patients had numerically greater impairments in work and productivity, measured by the Work Productivity and Activity Impairment questionnaire and the Sheehan Disability Scale. There was considerable heterogeneity in treatments used in the Portuguese subgroup, with 31 different treatment strategies reported. At Month 6, a greater proportion of Portuguese patients (n = 27) achieved either response or remission (40.7 %) compared with the total study population (n = 306; 26.5 %).

Limitation

Small patient numbers in the Portuguese subgroup.

Conclusions

The higher baseline disease severity and productivity impairment in the Portuguese subgroup relative to the total study population suggests notable societal disease burden, whilst the heterogeneity of treatments used indicates a lack of clinical consensus. Despite Portuguese patients reporting higher rates of response and remission than the overall study population, most patients failed to respond to treatment, highlighting an unmet need for TRD in Portugal.