Acceptability impacts on patient preference, treatment adherence and outcomes. However, acceptability has typically been assessed by attrition rates, which do not reflect the complexity of the construct or provide the details necessary for meaningful interpretation or potential for refinement. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation that could be a first line treatment in major depressive disorder (MDD). We examined the acceptability of a community-based tDCS treatment for MDD. Acceptability was assessed by questionnaires and individual interviews at three timepoints: baseline, following course of treatment, and a long term 6-month follow up. Participants were 26 MDD (19 women) in a current depressive episode of moderate to severe severity. Treatment was 6-week course of tDCS, provided in a bifrontal montage with real-time remote supervision at each session. Participants consistently endorsed the tDCS sessions as being “very acceptable” from baseline to the follow up period. There was a significant increase in personal endorsement from “would strongly recommend” at the end of treatment to “would very strongly recommend” at follow up. Individual interviews demonstrated four main themes: effectiveness, side effects, time commitment, and feeling held, support and contained. Real-time supervision of each session may not reflect usual treatment protocols and could have influenced acceptability. Acceptability remained high throughout the course of treatment and at follow up. The theme of feeling contained could be specific to this protocol. Emergence of novel themes demonstrates the benefits of obtaining qualitative views for intervention refinement.
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