Prevalence of Mental Health Conditions Among Individuals With Sickle Cell Disease in Texas Medicaid
Author(s)
Blessing I. Okoye, BPharm1, Ayobami A. Aiyeolemi, BPharm1, Gloria N. Odonkor, MPH1, Ananya Bhalla, BSc2, Jamie C. Barner, PhD1, Samantha Catanzano, PhD3;
1University of Texas at Austin, Division of Health Outcomes, Austin, TX, USA, 2University of Texas at Austin, College of Natural Science, Austin, TX, USA, 3University of Texas at Austin, Division of Pharmacy Practice, Austin, TX, USA
1University of Texas at Austin, Division of Health Outcomes, Austin, TX, USA, 2University of Texas at Austin, College of Natural Science, Austin, TX, USA, 3University of Texas at Austin, Division of Pharmacy Practice, Austin, TX, USA
Presentation Documents
OBJECTIVES: Individuals with sickle cell disease (SCD) experience mental health conditions (MHC) that may negatively impact health outcomes. This study aims to describe the overall and individual prevalence of MHC and to compare the demographic and clinical characteristics of individuals with SCD only and those with SCD and MHC (SCD+MHC) in Texas Medicaid.
METHODS: A retrospective analysis of Texas Medicaid data from 03/01/2012-05/31/2021 included subjects who were ≥3 years old, had ≥3 medical claims associated with an SCD diagnosis, and were continuously enrolled for ≥12 months after the index date (first claim for SCD). MHC were identified with ICD-9 and ICD-10 codes, and demographic (age, gender) and clinical characteristics (SCD-related complications, vaso-occlusive crisis [VOC], non-SCD-related comorbid medical conditions) were assessed. Descriptive and bivariate analyses were used.
RESULTS: Of the 3,618 (mean age=22.8±13.6) included, 20.8% had at least one MHC. The five most common MHC among individuals with SCD+MHC were substance use disorders (11.4%), depressive disorders (5.5%), anxiety (4.9%), bipolar disorder (2.5%), and schizophrenia spectrum and other psychotic conditions (1.9%). While no significant difference in age, those with SCD+MCH had a significantly higher proportion of males (34.0% vs 25.9%, p<.0001), had a significantly (p<.0001) higher mean number and proportion, respectively, of SCD-related complications (3.0±2.4 vs. 1.7±1.7; 87.0% vs. 70.1%), VOC (13.3±22.4 vs. 2.8±11.8; 71.9% vs. 41.5%) and non-SCD-related comorbid medical conditions (1.1±1.2 vs. 0.5±0.8; 59.8% vs. 32.6%) compared to SCD only.
CONCLUSIONS: The prevalence of MHC among individuals with SCD is high, and those with a comorbid MHC experience significantly worse health outcomes. Targeted interventions, including screening and treatment of MHC, and incorporating mental health specialists in the comprehensive care team are needed to improve patient outcomes.
METHODS: A retrospective analysis of Texas Medicaid data from 03/01/2012-05/31/2021 included subjects who were ≥3 years old, had ≥3 medical claims associated with an SCD diagnosis, and were continuously enrolled for ≥12 months after the index date (first claim for SCD). MHC were identified with ICD-9 and ICD-10 codes, and demographic (age, gender) and clinical characteristics (SCD-related complications, vaso-occlusive crisis [VOC], non-SCD-related comorbid medical conditions) were assessed. Descriptive and bivariate analyses were used.
RESULTS: Of the 3,618 (mean age=22.8±13.6) included, 20.8% had at least one MHC. The five most common MHC among individuals with SCD+MHC were substance use disorders (11.4%), depressive disorders (5.5%), anxiety (4.9%), bipolar disorder (2.5%), and schizophrenia spectrum and other psychotic conditions (1.9%). While no significant difference in age, those with SCD+MCH had a significantly higher proportion of males (34.0% vs 25.9%, p<.0001), had a significantly (p<.0001) higher mean number and proportion, respectively, of SCD-related complications (3.0±2.4 vs. 1.7±1.7; 87.0% vs. 70.1%), VOC (13.3±22.4 vs. 2.8±11.8; 71.9% vs. 41.5%) and non-SCD-related comorbid medical conditions (1.1±1.2 vs. 0.5±0.8; 59.8% vs. 32.6%) compared to SCD only.
CONCLUSIONS: The prevalence of MHC among individuals with SCD is high, and those with a comorbid MHC experience significantly worse health outcomes. Targeted interventions, including screening and treatment of MHC, and incorporating mental health specialists in the comprehensive care team are needed to improve patient outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH160
Topic
Epidemiology & Public Health
Disease
SDC: Mental Health (including addition), SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)