The influence of patient preference on depression treatment in primary care
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Background: The chronic illness model encourages consideration of patients’ treatment preferences. Moreover, research suggests that matching treatment to preference might affect outcomes for patients with depression.Purpose: This investigation explored factors associated with treatment preference matching and the effects of matching on depression treatment outcomes.Methods: Treatment preferences were assessed among primary care patients with depression participating in a large randomized trial of depression management. Patients were offered antidepressant medication and/or counseling based on preference and several other factors. Depression was assessed at 3 and 9 months.Results: Participants who preferred medication were older, were in worse physical health, and were more likely to already be taking antidepressants. Participants who preferred both medication and counseling evidenced greater agreement with the statement that depression is a medical illness. Overall, 72% of participants were matched with their preferred treatment; matched participants demonstrated more rapid improvement in depression symptomatology than unmatched participants.Conclusions: 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. The Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service supported this research. This article presents our findings and conclusions. It does not necessarily represent those of the Department of Veterans Affairs or Health Services Research and Development Service.
- Wagner EH, Austin BT, Von Korff M: Improving outcomes in chronic illness.Managed Care Quarterly. 1996,4:12–25.
- Schulberg HC, Katon W, Simon GE, Rush AJ: Best clinical practice: Guidelines for managing major depression in primary medical care.Journal of Clinical Psychiatry. 1999,60:19–26.
- Priest RG, Vize C, Roberts A, Roberts M, Tylee A: Lay people’s attitudes to treatment of depression: Results of opinion poll for Defeat Depression Campaign just before its launch.British Medical Journal. 1996,313:858–859.
- Churchill R, Khaira M, Gretton V, et al.: Treating depression in general practice: Factors affecting patients’ treatment preferences.British Journal of General Practice. 2000,50:905–906.
- Dwight-Johnson M, Sherbourne CD, Liao D, Wells KB: Treatment preferences among depressed primary care patients.Journal of General Internal Medicine. 2000,15:527–534. CrossRef
- Cooper LA, Gonzales JJ, Gallo JJ, et al.: The acceptability of treatment for depression among African-American, Hispanic, and White primary care patients.Medical Care. 2003,41:479–489. CrossRef
- Jorm AF, Korten AE, Jacomb PA, et al.: “Mental health literacy”: A survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment.Medical Journal of Australia. 1997,166:182–186.
- Dwight-Johnson M, Unutzer J, Sherbourne C, Tang L, Wells KB: Can quality improvement programs for depression in primary care address patient preferences for treatment?Medical Care. 2001,39:934–944. CrossRef
- Bedi N, Chilvers C, Churchill R, et al.: Assessing effectiveness of treatment of depression in primary care: Partially randomized preference trial.British Journal of Psychiatry. 2000,177:312–318. CrossRef
- Chilvers C, Dewey M, Fielding K, et al.: Antidepressant drugs and generic counseling for treatment of major depression in primary care: Randomized trial with patient preference arms.British Medical Journal. 2001,322:772–775. CrossRef
- Hedrick SC, Chaney EF, Felker B, et al.: Effectiveness of collaborative care depression treatment in Veterans’ Affairs primary care.Journal of General Internal Medicine. 2003,18:9–16. CrossRef
- Cebul RD: Randomized, controlled trials using the metro firm system.Medical Care. 1991,29:JS9-JS18.
- Williams Jr. JW, Barrett J, Oxman T, et al.: Treatment of dysthymia and minor depression in primary care: A randomized controlled trial in older adults.Journal of the American Medical Association. 2000,284:1519–1526. CrossRef
- McDonnell M, Anderson S, Fihn S: The Ambulatory Care Quality Improvement Project: A multisite information system for monitoring health outcomes. Annual Meeting of Department of Veterans Affairs Health Services Research and Development Service. Washington DC: 1998.
- Katon WJ, Von Korff M, Lin E, et al.: Collaborative management to achieve treatment guidelines: Impact on depression in primary care.The Journal of the American Medical Association. 1995,273:1026–1031. CrossRef
- Katon W, Von Korff M, Lin E, et al.: Stepped collaborative care for primary care patients with persistent symptoms of depression: A randomized trial.Archives of General Psychiatry. 1999,56:1109–1115. CrossRef
- Von Korff M, Gruman J, Schaefer J, Curry SJ, Wagner EH: Collaborative management of chronic illness.Annals of Internal Medicine. 1997,127:1097–1102.
- Unutzer J, Katon W, Callahan CM, et al.: Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial.Journal of the American Medical Association. 2002,288:2836–2845. CrossRef
- Padesky CA, Greenberger D:Clinician’s Guide to Mind Over Mood. New York: Guilford, 1995.
- Greenberger D, Padesky CA:Mind Over Mood. New York: Guilford, 1995.
- Malone DC, Billups SJ, Valuck RJ, Carter BL: Development of a chronic disease indicator score using a Veterans Affairs Medical Center medication database. IMPROVE Investigators.Journal of Clinical Epidemiology. 1999,52:551–557. CrossRef
- Von Korff M, Wagner EH, Saunders K: A chronic disease score from automated pharmacy data.Journal of Clinical Epidemiology. 1992,45:197–203. CrossRef
- Sales AE, Liu CF, Sloan KL, et al.: Predicting costs of care using a pharmacy-based measure risk adjustment in a veteran population.Medical Care. 2003,41:753–760. CrossRef
- Kazis LE, Ren XS, Lee A, et al.: Health status in VA patients: Results from the Veterans Health Study.American Journal of Medical Quality. 1999,14:28–38. CrossRef
- Kazis LE: The Veterans SF-36 Health Status Questionnaire: Developments and application in the Veterans Health Administration.Medical Outcomes Trust Monitor. 2000,5:1–14.
- Derogatis LR, Lipman RS, Rickels R, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist: A measure of primary symptom dimensions.Psychological Measurements in Psychopharmacology. 1974,7:79–110.
- Lin EH, Von Korff M, Russo J, et al.: Can depression treatment in primary care reduce disability? A stepped care approach.Archives of Family Medicine. 2000,9:1052–1058. CrossRef
- Mulrow CD, Williams JW, Gerety MB, et al.: Case-finding instruments for depression in primary care settings.Annals of Internal Medicine. 1995,122:913–921.
- Randall M, Kilpatrick KE, Pendergast JF, Jones KR, Vogel WB: Differences in patient characteristics between Veterans Administration and community hospitals: Implications for VA planning.Medical Care. 1987,25:1099–1104. CrossRef
- Wolinsky FD, Coe RM, Mosely RR, Homan SM: Veterans’ and Nonveterans’ use of health services: A comparative analysis.Medical Care. 1985,23:1358–1371. CrossRef
- Schreiber R, Hartrick G: Keeping it together: How women use the biomedical explanatory model to manage the stigma of depression.Issues in Mental Health Nursing. 2002,23:91–105. CrossRef
- The influence of patient preference on depression treatment in primary care
Annals of Behavioral Medicine
Volume 30, Issue 2 , pp 164-173
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. HSR&D (152) VA Puget Sound Health Care System, 1660 South Columbian Way, 98108, Seattle, WA
- 2. Department of Health Services, University of Washington, USA
- 3. Health Services Research and Development Center of Excellence and Mental Health Service, VA Puget Sound Health Care System, USA
- 4. Department of Psychiatry and Behavioral Sciences, University of Washington, USA
- 5. Department of Health Services, University of Washington, USA
- 6. Mental Health Service VA Puget Sound Health Care System, USA