Impact of Telehealth on Health-Related Quality of Life in Depression: A Medical Expenditure Panel Survey Study

OBJECTIVES: Telehealth, or remote clinical services, is expanding across health systems as an alternative to in-person visits. However, little is known about the role and impact of telehealth in patients with mental health disorders. The objective of this study was to examine the differences in health-related quality of life (HRQoL) among major depressive disorder (MDD) patients utilizing telehealth versus non-telehealth services.

METHODS: This cross-sectional study utilized the 2020-2021 Medical Expenditures Panel Survey (MEPS) data. The study included MDD patients (aged ≥18) based on ICD-10 diagnosis codes. The telehealth visit captured any phone, video, and other service usage. The HQoL was based on the Veteran RAND-12 Item Health Survey (VR-12), focusing on the mental component summary (PCS) and physical component summary (PCS). Descriptive weighted analyses were used to examine patients with MDD. A multivariate regression model estimated the effect of telehealth utilization on HRQoL, adjusting for covariates based on the conceptual framework of the Wilson and Clary model.

RESULTS: The study involved 3.24 (95%CI:2.18-3.58) million patients diagnosed with MDD. Mean (SD) age was 52.91 (SD 0.87) years. Most of the MDD patients were females (74.92%), whites (74.11%), and were from the south (28.64%). Overall, 34.73% of MDD patients (95% CI:29.57%-37.89%) used telehealth services. Mean HRQoL MCS scores for telehealth and non-telehealth users were 41.07 (95%CI:39.47-42.67) and 43.17 (95%CI:41.98-44.36), respectively. Mean HRQoL PCS scores for telehealth users and non-users were 42.60 (95%CI:40.25-44.96) and 43.82 (95%CI:42.30-45.34), respectively. After adjusting for other factors, multivariate regression models showed telehealth users had lowered MCS by 2.09 units (95%CI:-3.87,-0.32]) and lowered PCS by 2.47 units (95%CI:-4.36,-0.58]) compared to non-users.

CONCLUSIONS: This study found that patients with MDD using telehealth services can have lower HRQoL than non-users. Additional studies are needed to understand the reasons for the HRQoL variation and the role of telehealth for mental health disorders.