OBJECTIVES: The time from chronic lymphocytic leukemia (CLL) diagnosis to initial treatment can range from years to decades. This active surveillance period may provoke feelings of uncertainty, leading to symptoms of mental health (MH) disorders. We assessed MH burden-related healthcare resource use (MHB-HCRU) across treatment phases.

METHODS: This retrospective observational study using Optum Clinformatics Data Mart^® assessed MHB and cognitive impairment (CI) in adult patients diagnosed with CLL or initiating CLL treatment (2009–2021), excluding patients with MHB/CI encounters within 24 months pre-diagnosis. MHB-HCRU and CI-related HCRU (CI-HCRU) were based on diagnosis/prescription claims for MH (ie, anxiety, depression) and CI (ie, dementia, Alzheimer’s) post-CLL diagnosis (surveillance), first-line (1L), or second-line (2L) treatment and reported as mean encounters per patient per month (PPPM). Time to first MHB-HCRU and CI-HCRU among treatment-naïve patients with incident CLL was assessed using Kaplan-Meier methodology.

RESULTS: Among 7734 patients (mean age 73.03–75.58 years) assessed for MHB, patients on surveillance (n=2253) versus those initiating 1L (n=4011) or 2L (n=1470) had greater rates of MH encounters PPPM (mean [SD]=0.21 [1.33] versus 1L: 0.07 [0.31], P<0.00001; and 2L: 0.10 [0.46]). Results were similar in the CI cohort (N=11,755).

Among 2253 patients on surveillance assessed for MHB-HCRU, 21% experienced ≥1 encounter during a median (IQR) follow-up of 9.92 (2.23–28.52) months. Among patients with an encounter, the median (IQR) time to MH encounter was 1.64 (0.03–8.38) months, and 41% experienced a MH encounter within 1-month of follow-up. Similar results were seen for the CI cohort.

CONCLUSIONS: CLL patients on surveillance had a greater rate of MH encounters when compared with new 1L and 2L patients. Among CLL patients who experienced an encounter, >40% experienced an encounter within 1 month of diagnosis, highlighting the importance of the physician’s role in the assessment and treatment of MH in CLL patients.