Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data
AbstractBackground.Adult attention-deficit/hyperactivity disorder (aADHD) is still a largely unrecognized psychiatric condition despite its strong impact on individuals’ well-being. Here, we describe the healthcare situation of individuals with incident aADHD over 4 years before and 4 years after in...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2020-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382000084X/type/journal_article |
| _version_ | 1811156312799576064 |
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| author | Berit Libutzki Melanie May Markus Gleitz Michael Karus Benno Neukirch Catharina A. Hartman Andreas Reif |
| author_facet | Berit Libutzki Melanie May Markus Gleitz Michael Karus Benno Neukirch Catharina A. Hartman Andreas Reif |
| author_sort | Berit Libutzki |
| collection | DOAJ |
| description | AbstractBackground.Adult attention-deficit/hyperactivity disorder (aADHD) is still a largely unrecognized psychiatric condition despite its strong impact on individuals’ well-being. Here, we describe the healthcare situation of individuals with incident aADHD over 4 years before and 4 years after initial administrative diagnosis.Methods.A retrospective, longitudinal cohort analysis was conducted using German claims data. The InGef database contained approximately 5 million member-records from over 60 nationwide statutory health insurances (SHI). Individuals were indexed upon initial diagnosis of aADHD.Results.Average age at diagnosis of aADHD was 35 years, and 60% of individuals were male. Comorbidities, resource use, and healthcare costs were substantial before initial diagnosis and decreased within the 4 years thereafter. Only 32% of individuals received initial ADHD medication and adherence was low. The majority received psychotherapy. Individuals with initial ADHD medication showed the highest share in comorbidities, physician visits, medication use for comorbidities, psychotherapy, and costs. Overall, healthcare costs were at over €4,000 per individual within the year of aADHD diagnosis.Conclusions.We conclude that earlier recognition of aADHD could prevent the development and aggravation of comorbid mental illnesses. At the same time, comorbid conditions may have masked (“over-shadowed”) aADHD and delayed diagnosis. The burden of disease in aADHD is high, which was noticeable especially among individuals who received initial ADHD-medication, suggesting that psychopharmacological treatment was mainly considered for the most severely ill. We conclude that measures to facilitate access of aADHD patients to clinical experts are required to improve reality of care in the outpatient setting. |
| first_indexed | 2024-04-10T04:49:28Z |
| format | Article |
| id | doaj.art-894fce7d6a054d528b1fb369528c8bc0 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:28Z |
| publishDate | 2020-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-894fce7d6a054d528b1fb369528c8bc02023-03-09T12:33:57ZengCambridge University PressEuropean Psychiatry0924-93381778-35852020-01-016310.1192/j.eurpsy.2020.84Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims dataBerit Libutzki0https://orcid.org/0000-0002-0826-281XMelanie May1https://orcid.org/0000-0003-3910-773XMarkus Gleitz2Michael Karus3Benno Neukirch4https://orcid.org/0000-0002-1130-9877Catharina A. Hartman5Andreas Reif6https://orcid.org/0000-0002-0992-634XDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands HGC Healthcare Consultants GmbH, Düsseldorf, GermanyHGC Healthcare Consultants GmbH, Düsseldorf, GermanyMEDICE Arzneimittel Pütter GmbH & Co KG, Iserlohn, GermanyMEDICE Arzneimittel Pütter GmbH & Co KG, Iserlohn, GermanyHochschule Niederrhein, University of Applied Sciences, Krefeld, GermanyDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, GermanyAbstractBackground.Adult attention-deficit/hyperactivity disorder (aADHD) is still a largely unrecognized psychiatric condition despite its strong impact on individuals’ well-being. Here, we describe the healthcare situation of individuals with incident aADHD over 4 years before and 4 years after initial administrative diagnosis.Methods.A retrospective, longitudinal cohort analysis was conducted using German claims data. The InGef database contained approximately 5 million member-records from over 60 nationwide statutory health insurances (SHI). Individuals were indexed upon initial diagnosis of aADHD.Results.Average age at diagnosis of aADHD was 35 years, and 60% of individuals were male. Comorbidities, resource use, and healthcare costs were substantial before initial diagnosis and decreased within the 4 years thereafter. Only 32% of individuals received initial ADHD medication and adherence was low. The majority received psychotherapy. Individuals with initial ADHD medication showed the highest share in comorbidities, physician visits, medication use for comorbidities, psychotherapy, and costs. Overall, healthcare costs were at over €4,000 per individual within the year of aADHD diagnosis.Conclusions.We conclude that earlier recognition of aADHD could prevent the development and aggravation of comorbid mental illnesses. At the same time, comorbid conditions may have masked (“over-shadowed”) aADHD and delayed diagnosis. The burden of disease in aADHD is high, which was noticeable especially among individuals who received initial ADHD-medication, suggesting that psychopharmacological treatment was mainly considered for the most severely ill. We conclude that measures to facilitate access of aADHD patients to clinical experts are required to improve reality of care in the outpatient setting.https://www.cambridge.org/core/product/identifier/S092493382000084X/type/journal_articleAdult ADHD (aADHD)claims datacomorbiditieshealthcare costsmedication |
| spellingShingle | Berit Libutzki Melanie May Markus Gleitz Michael Karus Benno Neukirch Catharina A. Hartman Andreas Reif Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data European Psychiatry Adult ADHD (aADHD) claims data comorbidities healthcare costs medication |
| title | Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data |
| title_full | Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data |
| title_fullStr | Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data |
| title_full_unstemmed | Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data |
| title_short | Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data |
| title_sort | disease burden and direct medical costs of incident adult adhd a retrospective longitudinal analysis based on german statutory health insurance claims data |
| topic | Adult ADHD (aADHD) claims data comorbidities healthcare costs medication |
| url | https://www.cambridge.org/core/product/identifier/S092493382000084X/type/journal_article |
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