BACKGROUND: Recent evidence has shown that the economic costs of depression increase greatly when depression is present with painful physical symptoms (PPS).
OBJECTIVES: The objectives of this study were to identify depressed patients who have comorbid conditions with PPS and to provide a descriptive analysis, including demographics and healthcare utilization, for depressed patients with painful symptom diagnoses.
METHODS: We identified patients with an index diagnosis of major depressive disorder (ICD-9 codes 296, 309, or 311) between 1 January 1996 and 31 December 1998, using Saskatchewan Health databases. After excluding patients with comorbid psychosis, certain patients with schizophrenia, and patients who received mood stabilizer monotherapy and had no diagnosis of epilepsy, a pain algorithm was applied to classify depressed patients with and without pain. 63% were women. Seventeen per cent of the patients were under age 50, and 15% were age 65 or older (mean age of 58 10 years). Thirteen patients (11%) received multiple vertebroplasties. The main indications for a vertebroplasty at the date of a procedure were pathological fracture of vertebrae (56%) and VCF (20%). Of the 121 patients, 58 patients (48%) had a history of VCF, and 44 patients (36%) had a bone cancer diagnosis (just over half of these patients had at least one oncology visit). Radiologists performed half of all procedures, followed by orthopedic surgeons (30%) and neurosurgeons (10%). The number of vertebroplasty procedures increased by 55% after 1 September 2003, the date the insurer began to reimburse for this procedure for VCF.
CONCLUSIONS: Although vertebroplasty was used infrequently in this large privately-insured population, its utilization has been increasing. Additional research is underway to assess the long-term impact of vertebroplasty on post-vertebroplasty recurrent VCFs.
