PREVALENCE OF DEPRESSION AMONG ADULTS WITH SICKLE CELL DISEASE IN TEXAS MEDICAID
Author(s)
Pin Hsuan Liao, M.S.1, Hyeun Ah KANG, MEd, MS, RPh, PhD1, Jamie Barner, PhD1, Kristin Richards, BS, MS, RPh, PhD1, Desiree Azizoddin, Psy.D.2;
1University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2Dana Farber Cancer Institute, Department of Supportive Oncology, Boston, MA, USA
1University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2Dana Farber Cancer Institute, Department of Supportive Oncology, Boston, MA, USA
OBJECTIVES: Depression is a significant comorbidity in sickle cell disease (SCD), yet comprehensive data on its prevalence remain limited. This study aimed to: (1) estimate annual depression prevalence among Texas Medicaid adults with SCD, (2) examine prevalence trends across age groups, and (3) compare depression prevalence between adults with SCD and the Texas Medicaid general population.
METHODS: This retrospective cross-sectional study utilized 2016-2022 Texas Medicaid claims. Inclusion required adults (18-63 years) with ≥1 inpatient or ≥2 outpatient SCD-related claims. Annual prevalence was calculated as the number of individuals with ≥1 depression claim divided by the total number of eligible SCD individuals with ≥1 encounter in the calendar year. Prevalence was stratified by age group and sex. Descriptive statistics were used to examine temporal trends and depression prevalence in the SCD and overall Medicaid adult populations.
RESULTS: Overall annual depression prevalence among patients with SCD increased from 20.3% (2016) to 25.2% (2022), peaking at 25.7% (2020). Depression prevalence generally increased with age, with the 45-54/ 55-63 age groups showing the highest rates (27.0-34.2% and 22.6-33.9%, respectively), while the 18-21 age group exhibited the lowest (13.9-20.9%). Females showed higher prevalence than males across all years (22.0-28.7% vs. 16.6-20.5%). All age groups demonstrated upward trends with the oldest group experiencing the largest increase. General population showed increasing prevalence from 11.5% (2016) to 13.9% (2022), though lower than patients with SCD. Patients with SCD consistently demonstrated 1.8 times higher depression rates than the general population.
CONCLUSIONS: Medicaid adult enrollees with SCD experience substantially elevated depression rates compared to the overall Medicaid population, with rates nearly double across all years. Increasing trends across all age groups, particularly older adults, indicate a growing mental health burden in SCD. These findings underscore the critical need for routine depression screening and integrated mental health services as standard components of comprehensive SCD care.
METHODS: This retrospective cross-sectional study utilized 2016-2022 Texas Medicaid claims. Inclusion required adults (18-63 years) with ≥1 inpatient or ≥2 outpatient SCD-related claims. Annual prevalence was calculated as the number of individuals with ≥1 depression claim divided by the total number of eligible SCD individuals with ≥1 encounter in the calendar year. Prevalence was stratified by age group and sex. Descriptive statistics were used to examine temporal trends and depression prevalence in the SCD and overall Medicaid adult populations.
RESULTS: Overall annual depression prevalence among patients with SCD increased from 20.3% (2016) to 25.2% (2022), peaking at 25.7% (2020). Depression prevalence generally increased with age, with the 45-54/ 55-63 age groups showing the highest rates (27.0-34.2% and 22.6-33.9%, respectively), while the 18-21 age group exhibited the lowest (13.9-20.9%). Females showed higher prevalence than males across all years (22.0-28.7% vs. 16.6-20.5%). All age groups demonstrated upward trends with the oldest group experiencing the largest increase. General population showed increasing prevalence from 11.5% (2016) to 13.9% (2022), though lower than patients with SCD. Patients with SCD consistently demonstrated 1.8 times higher depression rates than the general population.
CONCLUSIONS: Medicaid adult enrollees with SCD experience substantially elevated depression rates compared to the overall Medicaid population, with rates nearly double across all years. Increasing trends across all age groups, particularly older adults, indicate a growing mental health burden in SCD. These findings underscore the critical need for routine depression screening and integrated mental health services as standard components of comprehensive SCD care.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH34
Topic
Epidemiology & Public Health
Disease
SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)