Patients with Depression and/or Anxiety Having Arthroscopic RCR Show Decreased Number of Prescriptions and Number of Psychotherapy Sessions in the Year Following Surgery.

PURPOSE: To determine the association between postoperative utilization of psychological treatment and preoperative depression and/or anxiety in patients who have undergone arthroscopic rotator cuff repair (RCR).

METHODS: The Truven Healthcare Marketscan database identified patients who underwent arthroscopic RCR between January 2009 and December 2016. We included all patients with diagnosis codes associated with either depression or anxiety prior to RCR. Patients were excluded if they did not have complete coverage for one year prior to or following surgery, or if they had arthroscopic RCR in the year prior to the index surgical procedure. We compared the proportion of patients with preoperative depression or anxiety who filled a prescription and had psychotherapy procedural codes in the year prior to and the year following arthroscopic RCR, RESULTS: A total of 170,406 patients that underwent RCR, of which depression and/or anxiety were identified in 46,737 patients (43.7% male). Of the 46,737 patients, 19.6% filled a prescription for a depression/anxiety medication at least once in the year prior to surgery. Of this subset of patients, 41.5% did not fill a prescription for depression or anxiety medication after surgery, while 32.6% continued medication use, but demonstrated a median 30-day reduction in the number of days' worth of medication. Similarly, 13.1% of patients were attending psychotherapy sessions preoperatively, but 76.6% of those patients either stopped or reduced the amount of psychotherapy sessions in the year following RCR.

CONCLUSION: Patients with depression and/or anxiety having arthroscopic RCR show decreased number of prescriptions and number of psychotherapy sessions in the year following surgery.