Factors affecting antidepressant use by patients requiring home parenteral nutrition

Abstract

Background Home parenteral nutrition (HPN) is a life‐saving therapy for patients with chronic intestinal failure but can be associated with a degree of psychological distress. The factors associated with the need for antidepressants (ADs) in this cohort have not yet been described. Methods The study involved prospective data collection from patients attending an HPN clinic at a national intestinal failure referral center. Patients requiring HPN as a result of active malignancy were excluded. Patients were divided in 2 groups according to AD usage; demographic, anthropometric, socioeconomic characteristics, and intravenous supplementation (IVS) regimens were compared between groups. Results A total of 184 patients were recruited between July 2018 and April 2019, with an overall prevalence of AD use of 41.7% (70/168 patients). Daily mean IVS volume was significantly higher among patients taking AD (“AD” group; 2125.48 ± 991.8 ml/day, “no‐AD” group; 1828.54 ± 847.0 ml/day, P = .039), with the proportion of patients needing high‐volume IVS (≥3000 ml/day) being 3 times higher in the AD group (20.0%(14/70 patients) vs 6.1% (6/98 patients), P = .006). The average energy IVS infusion per day was similar between the groups. Conclusion This is the first study to demonstrate that AD use correlates with higher IVS volume rather than energy requirements in HPN patients, suggesting that high IVS volume requirements may be better associated with the patient's disease burden. Early and tailored mental health intervention may be beneficial in those with high IVS volume requirements.

Quality of Life in the Management of Home Parenteral Nutrition

“…A recent study suggests that the infusion volume affects the use of antidepressants in patients with chronic intestinal failure. The authors hypothesize that this could be related to the overall disease burden and suggest to closely monitor patients with a high volume of intravenous supplementation, which is typically accompanied by a longer period of cycling PN [27] .…”

Factors associated with strong opioid use for noncancer pain in patients with chronic intestinal failure

“…This was a retrospective cohort study of patients attending a HPN clinic at a national UK IF referral center. The clinical database was prospectively maintained as elaborated in our previous article by Cloutier et al that evaluated antidepressant usage in this patient cohort 19 . In brief, patients were included if they were HPN‐dependent because of a benign condition between July 2018 and April 2019.…”

“…The clinical database was prospectively maintained as elaborated in our previous article by Cloutier et al that evaluated antidepressant usage in this patient cohort. 19 In brief, patients were included if they were HPN‐dependent because of a benign condition between July 2018 and April 2019. All patients included in the study signed an informed consent form.…”

Nutrición parenteral: la prisión que permite sobrevivir ante una condición de insuficiencia intestinal

“…En un estudio en 85 pacientes, el 56% tenía niveles clínicos de ansiedad o depresión (20) . En otro estudio se correlacionó el uso de antidepresivos con el volumen de nutrición parenteral, y fue en los pacientes con alto volumen (3 veces mayor) en quienes usaban antidepresivos (23) . Además, los pacientes con pobres redes de apoyo y en edad laboral son más vulnerables al impacto psicológico (20) .…”