Abstract 12897: The Synergistic Effects of Fatigue and Depression on Use of Medical Services in Patients With Heart Failure
Introduction: Heart failure (HF) is an expensive clinical condition, which imparts a considerable burden on patients and society. Fatigue and depression are the most common physical and psychological symptoms, and together may have more impact on use of medical services than one symptom alone.
Hypothesis: We hypothesized that fatigue and depression would have the synergistic effects on use of different medical services controlling for common covariates.
Methods: We conducted a secondary data analysis of a university medical center electronic database (N = 582, mean age 63 ± 14 years, 54% males). Data were collected on fatigue, depression, covariates (i.e., sociodemographic and clinical characteristics, vital signs, laboratory tests [serum troponin, albumin, triglycerides, creatinine, sodium, hemoglobin, monocytes, and neutrophils], and medication [beta-blockers, antidepressants, and angiotensin converting enzyme inhibitors]), and frequency of medical service use based on CPT codes. Patients were categorized into one of four symptom groups based on ICD-9 codes: no symptom, fatigue only, depression only, and fatigue and depression. General linear regression was used to analyze the data.
Results: The mean number of total medical service use was 96.5 ± 84.3 over 3 years. The mean number in the fatigue and depression group (152.6 ± 103.4) was greater than the fatigue only (122.9 ± 97.9, p = .016), depression only (84.3 ± 62.0, p < .001), and no symptom groups (61.7 ± 46.7, p < .001) controlling for covariates. In further analyses, the numbers of medical service use in the fatigue and depression group compared with the other groups were greater in evaluation and management services (e.g., inpatient and outpatient services, p < .001), radiology services (e.g., diagnostic imaging and ultrasound, p < .001), and medicine services (e.g., medical services and procedures such as cardiovascular, p < .05).
Conclusion: Fatigue and depression showed synergistic impact on the number of total medical service use. Clinicians should assess and manage fatigue and depression together and provide interventions to manage them effectively to assist in reducing medical service use.
Author Disclosures: S. Heo: Research Grant; Significant; the Translational Research Institute (TRI), grant UL1TR000039 through the NIH National Center for Research Resources and National Center for Advancing Translational Sciences. J. McSweeney: None. P. Tsai: None. S. Ounpraseuth: None.
- © 2016 by American Heart Association, Inc.