Difference in healthcare resource utilization and health-related quality of life between patients with major depressive disorder (MDD) and treatment-resistant depression (TRD) in a public hospital in Malaysia - a retrospective case-note review and cross-sectional survey

Lee KKC 1 , Mohamed NNE 2 , Abdul Aziz S 3 , Mohamad Nazri D 2 , Abdul Malek AZ 3 , Lim JS 4 Show all authors , Wu DB 4 , Aftab RA 5 , Thanimalai S 4 , Swaminathan M 4 , Choon JWY 6 , Sellappans R 4

Affiliations 

  • 1 School of Medicine and Health Sciences, Monash University Malaysia, Petaling Jaya, Selangor, Malaysia
  • 2 Clinical Research Centre, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
  • 3 Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
  • 4 School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
  • 5 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
  • 6 Faculty of Pharmacy, Centre for Drug Policy & Health Economics Research (CDPHER), Universiti Teknologi MARA, Shah Alam, Malaysia
Expert Opin Pharmacother, 2025 Feb 28.
PMID: 40015692 DOI: 10.1080/14656566.2025.2472976

Abstract

BACKGROUND: Major depressive disorder (MDD) is a growing global health concern, with its economic impact projected to reach USD 6.0 trillion by 2030. Treatment-resistant depression (TRD), characterized by non-responsiveness to initial treatments, adds a significant cost burden. In Malaysia, the National Health and Morbidity Survey 2023 reported a rising prevalence of depression in Malaysia, affecting approximately one million individuals.

RESEARCH DESIGN AND METHODS: A combined retrospective chart review and cross-sectional survey was conducted at the Psychiatry and Mental Health Clinic of Hospital Kuala Lumpur (HKL) over an 18-month period, examining 286 patients diagnosed with MDD or TRD. Data were analyzed from governmental and societal perspectives, including direct medical costs, indirect costs, and other resource utilization.

RESULTS: TRD patients exhibited significantly higher health-care utilization, including a fivefold increase in the likelihood of attending more than 10 consultations (p = 0.035) and greater use of second-generation antipsychotics (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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