Quality of life and productivity among esketamine responders in a real-world study in Australia and New Zealand.

Abstract

Treatment-resistant depression (TRD) is associated with severe depression, low quality of life (QoL) and reduced work productivity, which may increase risk of relapse, suicide and suboptimal response to treatment. Esketamine nasal spray plus a newly-initiated oral antidepressant (esketamine + OAD) has been shown to improve depression symptoms, QoL and productivity in patients with TRD; however real-world evidence is limited. This was a descriptive, exploratory post-hoc subgroup analysis of patients with TRD who received esketamine + OAD treatment over 16 weeks through an Early Access Program in Australia and New Zealand. This analysis aimed to describe response to esketamine + OAD (≥50% decrease in Hamilton Depression Rating Scale Index [HAMD-17] score at Week 16), including changes in depression severity, QoL and work productivity. QoL was assessed using the Assessment of QoL-8D (AQoL-8D) questionnaire and work productivity was assessed using the Workplace Productivity and Activity Impairment: Specific Health Problem Questionnaire (WPAI:SHP). Overall, 28 (33.3%) participants were identified as responders. Responders experienced mean improvements in HAMD-17 (71.2%), AQoL-8D (29.5%) and WPAI:SHP (≥11.9%) from Baseline to Week 16. The greatest improvement among AQoL-8D domains was observed in mental health (32.9%). The largest improvement in WPAI:SHP was seen in overall work productivity loss (35.9%). These findings describe concurrent improvements in symptoms, QoL and self-reported functioning among responders. Results should be interpreted with caution due to limitations conferred by the post-hoc design, short follow-up, small population sizes and missing data.