Indirect costs in patients with coronary artery disease and mental disorders: A systematic review and meta-analysis

Abstract

The aim of the present study was to systematically review the association of comorbid mental disorders with indirect health care costs in patients with coronary artery disease (CAD). A comprehensive database search was conducted for studies investigating persons with CAD and comorbid mental disorders (Medline, EMBASE, PsycINFO, Psyndex, EconLit, IBSS). All studies were included, which allowed for a comparison of indirect health care costs between CAD patients with comorbid mental disorders and CAD patients without mental disorders. The literature search revealed 4962 potentially relevant studies, out of which 13 primary studies met the inclusion criteria. Depression was investigated most often (N = 10), followed by anxiety disorders (N = 3) and any mental disorder not further specified (N = 3). All studies focused on return to work as indirect cost outcome. CAD patients with depression showed diminished odds for return to work, compared to CAD patients without depression (OR = 0.37; 95% CI: 0.27-0.51). The findings for comorbid anxiety and any mental disorder were inconsistent. Indirect health care costs were exclusively assessed by a patient self-report (N = 13). There is strong evidence for diminished odds of return to work in CAD patients with comorbid depression, highlighting the need for integrated CAD and depression care. With regard to other comorbid mental disorders, however, the evidence is sparse and inconclusive.

Direct and indirect costs in persons with chronic back pain and comorbid mental disorders—A systematic review

“…Three similar systematic reviews reported substantially higher incremental costs in patients with diabetes, coronary artery disease and asthma [4][5][6]. One explanation for the lower incremental costs associated with mental disorders in CBP patients could be that psychological and antidepressant drug treatments are already standard interventions in the treatment of CBP, which might help to bridge the gap between physical and mental health care [36][37][38].…”

“…Indirect costs such as work absenteeism represents a majority of overall costs associated with CBP [1,2]. Systematic reviews on costs in patients with other medical diseases than CBP reported substantially increased direct and indirect costs in medically ill patients with comorbid mental disorders [4][5][6].…”

“…2) Are there differences in this association with regard to specific comorbid mental disorders? patients with comorbid mental disorders", funded by the Landesstiftung Baden-Württemberg [4][5][6]10].…”

Return to work after coronary revascularization procedures and a patient’s job satisfaction: A prospective study

“…Several studies have demonstrated that job satisfaction is an important factor influencing workers' health [25,26] and also professional outcomes, such as increased absenteeism and turnover, and decreased performance and motivation [27][28][29]. Moreover, previous studies have clearly demonstrated that occupational stress and mental distress make a significant contribution to the risk of CHD and, therefore, preventive interventions may benefit both RTW process and cardiac prognosis [2,[40][41][42]. In view of the influence of job satisfaction on the RTW process, it is important to understand which factors produce job satisfaction among employees who return to work after a long-term period of sick leave due to cardiac health problems.…”

“…It accounts for 1.8 million deaths each year, and involves major economic costs as well as human costs for Europe [1]. In recent decades, thanks to advances in diagnostic and therapeutic procedures, and thanks to improvement in rehabilitation programs, death rates have been falling and the prevalence of older workers with CHD, after a surgery/rehabilitation, has been consistently and constantly increasing [2]. The main goal of cardiac rehabilitation (CR) is to facilitate the return to social and professional life as similar as…”