Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients

Abstract

Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1) investigate treatment preferences for depression including internet-based interventions and (2) examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.Results: Patients had a mean age of 43.9 years (SD = 13.8) and more than two thirds (68.6%) were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.

Internet-Based Cognitive Behavior Therapy Only for the Young? A Secondary Analysis of a Randomized Controlled Trial of Depression Treatment

“…Interestingly, the present study contrasts the results of Dorow et al (18) who found that preferences for Internet-based interventions as part of depression treatment tended to decrease with age. Moreover, in a qualitative study aiming to investigate the acceptability of online self-management for depression in individuals with obesity, Löbner et al (43) found that also healthcare professionals consider younger patients as the preferred target group for iCBT use.…”

Transdiagnostic Tailored Internet- and Mobile-Based Guided Treatment for Major Depressive Disorder and Comorbid Anxiety: Study Protocol of a Randomized Controlled Trial

“…However, utilizing internet interventions for the treatment of mental disorders can also pose some challenges, such as low treatment commitment, incompatibleness of personal characteristics and treatment modality self-help, and missing or limited individualization options which may lead to higher dropout rates and decreased overall efficacy ( 29 – 31 ). To overcome some of these issues, their impact must be carefully considered during the study design phase and strategies to diminish negative effects should be incorporated, e.g., adherence monitoring, therapeutic contact through guidance, and individual tailoring.…”

Improving depression outcomes among Australian primary care patients: protocol for a cluster randomised controlled trial

“…This includes our work that shows that many patients with elevated depression are not identified as depressed by their doctors 7. Research by others has shown that patients have varied preferences for the management of psychological concerns 29. As a consequence, unlike other screening trials, our screening assessment covers both patient depressive symptoms and preferences for management.…”