Treatment Patterns and Characteristics of Patients with Post-Traumatic Stress Disorder (PTSD): A Retrospective Claims Analysis Among Commercially Insured Population

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Oct 30

PMID 39475900

Authors

Filip Stanicic

Vladimir Zah

Dimitrije Grbic

Debra de Angelo

Wendy Bibeau

Affiliations

Soon will be listed here.

Abstract

Objective: This retrospective claims analysis explored the treatment utilization and characteristics among patients with post-traumatic stress disorder (PTSD) of different severity.

Methods: The index date was the first PTSD claim. The analysis observed 12 months pre- and 24 months post-index. Adults with insurance gaps, cancer, or acute PTSD during the observation were excluded. Patients were categorized into three severity cohorts based on treatment and healthcare services utilization for PTSD: 1. Baseline PTSD (BP) (no PTSD visits post-index, no FDA-approved medications/ psychotherapy, and no severe mental health comorbidities); 2. PTSD without Comorbidities (PwoC) (≥1 PTSD visits post-index and no severe mental health conditions); 3. PTSD with Comorbidities (PwC) (≥1 PTSD visits post-index and severe mental health comorbidities present). For the primary analysis, cohorts were propensity-score matched. A sub-analysis examined patients with PTSD and Substance or Alcohol Use Disorder (SUD/AUD).

Results: The primary analysis observed 1714 BP, 1681 PwoC, and 1681 PwC patients. Treatment utilization rates were highest among PwC vs. other cohorts (84.5% psychotherapy, 76.1% off-label medications, and 26.1% FDA-approved medications [p<0.001]). PwC cohort also had the highest number of psychotherapy sessions and medication prescriptions per patient (20.1 sessions, 12.6 off-label prescriptions, and 2.0 FDA-approved prescriptions [p<0.001]). The proportion of days covered (PDC) indicated low medication adherence (0.25-0.40) with adherent patient rates (PDC ≥0.80) between 8.0-17.5%. The SUD/AUD sub-analysis identified 85 BP, 537 PwoC, and 3154 PwC patients. Conclusions were similar, with PwC cohort having highest treatment utilization rates (87.1% psychotherapy, 85.0% off-label medications, 28.2% FDA-approved medications [p≤0.013] with 24.4 sessions, 16.1 off-label prescriptions, and 2.0 FDA-approved prescriptions per patient [p≤0.002]). Only 4.7-11.4% of patients were adherent.

Conclusions: PwC patients received psychotherapy and pharmacotherapy more frequently than PwoC and BP patients. Medication adherence among treated patients was low. Patients with SUD/AUD had numerically higher treatment utilization and lower medication adherence.

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