Evaluation of Treatment Complexity and Initial Behavioral Health Screenings in Patients with Cystic Fibrosis

Abstract

Purpose: The purpose of this study is to investigate the potential association between patient factors, including treatment complexity score (TCS), and initial behavioral health screening outcomes in patients with cystic fibrosis (CF).

Introduction: CF, a multi-organ genetic disease, often results in time-consuming treatment regimens, frequent hospitalizations, and disease progression. High treatment burden may contribute to behavioral health complications that can negatively impacting health outcomes.

Methods: This was a secondary analysis of de-identified data from a quality improvement initiative on implementing guideline recommended behavior health screenings in an accredited, CF Care Center in patients ages 12 years and older. TCS was calculated using previous method in literature and modified to account for other chronic medications for comorbidities as well as CFTR modulator use. Inclusion criteria was complete medication data and generalized anxiety disorder-7 (GAD-7) and/or patient health questionnaire-9 (PHQ-9) results. Data included demographics and medications at time of initial screening. Statistical analysis consisted of descriptive statistics including Wilcoxon Rank Sum, Chi square, and Fisher's Exact tests.

Results: A significant difference was observed within the demographic as well as GAD-7 and PHQ-9 classification in respect to pre-existing comorbidities of anxiety and depression, respectively. Within the modified treatment complexity score (MTC) grouped by PHQ-9 and GAD-7 score classification, no significant differences were seen.

Conclusion: No significant difference was observed in modified TCS between patients who screened moderate to severe in the depression and anxiety screenings. Multiple patient specific factors may contribute to positive screenings describing the complex nature of behavioral health.