The influence of patient preference on depression treatment in primary care

Lin, Patricia; Campbell, Duncan G.; Chaney, Edmund F.; Liu, Chuan Fen; Heagerty, Patrick J.; Felker, Bradford; Hedrick, Susan C.

doi:10.1207/s15324796abm3002_9

Cited by 174 publications

(134 citation statements)

References 22 publications

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“…(Davidson et al, 2004). Patient preferences for care are an important facet of retention in, and satisfaction with, psychotherapies (Iacoviello et al, 2007;Lin et al, 2005). Future research should address whether depressive vulnerabilities, similar to those assessed in this and previous studies, do in fact correlate with treatment preferences.…”

Section: Tale 4 About Here Discussionmentioning

confidence: 72%

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Keegan

Conroy

Doyle

2016

Journal of Affective Disorders

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Section: Tale 4 About Here Discussionmentioning

confidence: 72%

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Keegan

Conroy

Doyle

2016

Journal of Affective Disorders

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“…22 Most of our participants reported that they would have liked more say in their choice of treatments. Implementing systems to solicit treatment preferences of persons diagnosed with depression and coordination with counseling resources could substantially improve outcomes given the evidence that providing patients with their preferred mode of treatment increases both treatment uptake and adherence 13,14 and that more patients seem to desire counseling versus medication for treatment of depression. 29 -31 A number of limitations of this study must be acknowledged.…”

Section: Table 5 Participant Statements About Participation In Treatmentioning

confidence: 99%

“…Many persons diagnosed with depression do not commence treatment for it, 9 and the majority of persons who do enter treatment do not receive their preferred type of treatment, even though this seems to lead to better outcomes. 13,14 Furthermore, many persons starting treatment do not complete an adequate treatment course. 15 The US Preventive Services Task Force "recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up" with a grade B recommendation, 16 as such systems have been demonstrated to improve health status and, in some instances, to reduce health care costs.…”

mentioning

confidence: 99%

A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education

Saver¹,

Van-Nguyen²,

Keppel³

et al. 2007

The Journal of the American Board of Family Medicine

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Purpose: Depression is one of the most commonly encountered chronic conditions in primary care, yet it remains substantially underdiagnosed and undertreated. We sought to gain a better understanding of barriers to diagnosis of and entering treatment for depression in primary care.Methods: We conducted and analyzed interviews with 15 subjects currently being treated for depression recruited from primary care clinics in an academic medical center and an academic public hospital. We asked about experiences with being diagnosed with depression and starting treatment, focusing on barriers to diagnosis, subject understanding of depression, and information issues related to treatment decisions.Results: Subjects reported many visits to primary care practitioners without the question of depression being raised. The majority had recurrent depression. Many reported that they did not receive enough information about depression and its treatment options. In the majority of cases, practitioners decided the course of treatment with little input from the patients.Conclusions

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“…As for psychotherapy, according to Canadian recommendations a minimum of 12 visits are needed, but only 60% of patients having begun psychotherapy receive this much treatment (Duhoux et al, 2012) Under current guidelines, health professionals and, in particular, physicians need to take patient preferences into account in order to encourage adherence and effective treatment of depression (Trivedi et al, 2007;APA, 2000;NICE, 2009). Patients obtaining their preferred treatment (whether psychotherapy or pharmacotherapy) is associated with the best clinical results, particularly in terms of better remission rates but also in terms of a more significant reduction in depressive symptomatology (Clever et al, 2006;Gelhorn et al, 2011;Kocsis et al, 2009;Loh et al, 2007;Lin et al, 2005;Mergl et al, 2011). Persons suffering from depression often have very clear preferences (Churchill et al, 2000;Dwight-Johnson et al, 2000) and want to play an active role in treatment selection (Stacey et al, 2008;Arora and McHorney, 2000).…”

Section: Introductionmentioning

confidence: 99%

Treatment preferences in patients with first episode depression

Houle¹,

Villaggi²,

Beaulieu³

et al. 2013

Journal of Affective Disorders

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Background: Treatment preferences of patients suffering from depression may affect adherence and clinical outcomes. This study examines associations between patients' treatment preferences, their characteristics and illness representations of depression. Methods: Illness representations of depression (IPQ-R), treatment acceptability and preferences were assessed in 88 newly diagnosed patients with first episode depression. Other measures recorded: gender, age, education level, income, psychiatric comorbidity, depressive symptomatology (PHQ-9), a family history of depression, and current treatment of depression. Multiple logistic regression was used to identify factors associated with a preference for psychotherapy. Results: Psychotherapy was preferred by 41% of participants, while 31% favored antidepressants. Acceptability was strongly associated with preference. Patients preferring psychotherapy perceived that their depression has more serious consequences than those preferring medication and were more likely to attribute their depression to social causes than psychological or physical causes. Participants who preferred psychotherapy were more likely to be female, have a university degree and have a family history of depression. Limitations: The cross-sectional design precludes causal interpretations. Conclusions: Preferences vary according to gender, level of education, family history and illness representations. It may be important to provide accurate information on both treatments and discuss patients' preferences before prescribing treatment. Methods: Illness representations of depression (IPQ-R), treatment acceptability and preferences were assessed in 88 newly diagnosed patients with first episode depression. 1 Treatment preferences in patients with first episode depressionOther measures recorded: gender, age, education level, income, psychiatric comorbidity, depressive symptomatology (PHQ-9), a family history of depression, and current treatment of depression. Multiple logistic regression was used to identify factors associated with a preference for psychotherapy.Results: Psychotherapy was preferred by 41% of participants, while 31% favored antidepressants. Acceptability was strongly associated with preference. Patients preferring psychotherapy perceived that their depression has more serious consequences than those preferring medication and were more likely to attribute their depression to social causes than psychological or physical causes. Participants who preferred psychotherapy were more likely to be female, have a university degree and have a family history of depression. Limitations:The cross-sectional design precludes causal interpretations. Conclusions:Preferences vary according to gender, level of education, family history and illness representations. It may be important to provide accurate information on both treatments and discuss patients' preferences before prescribing treatment.

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The influence of patient preference on depression treatment in primary care

Abstract: Obtaining preferred treatment appears to contribute to improved treatment outcome. Continued attempts to assess for and accommodate treatment preferences might result in better response to depression treatment.

Cited by 174 publications

References 22 publications

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education

Treatment preferences in patients with first episode depression

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