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Treatment Decision-Making Preferences of Older Depressed Minority Primary Care Patients

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Abstract

Little research examined the decision-making preferences of older, racially and ethnically diverse minority patients with untreated depression. The study’s aims were to identify decision-making preferences and the characteristics associated with a more active preference in the decision-making process for general medical and depression treatment decisions. We assessed the preferred involvement in making general medical and depression treatment decisions of 201 older primary care patients with untreated depression. Linear regressions examined the association of sociodemographic and clinical characteristics with decision-making preference for both decision types. Majority of patients preferred shared decision-making for general medical and depression treatments. Female gender was associated with a preference for active decision-making for depression treatment. For this sample older depressed patients preferred sharing the decision-making responsibilities with physicians. To improve communication and the initiation and adherence to mental health care, physicians must consider older, minority patients’ preferences for involvement in the decision-making process.

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References

  • Adams, J. R., & Drake, R. E. (2006). Shared decision-making and evidence-based practice. Community Mental Health Journal, 42(1), 87–105.

  • Arora, N. K., & McHorney, C. A. (2000). Patient preferences for medical decision making: Who really wants to participate? Medical Care, 38, 335–341.

  • Ayalon, L., Areán, P. A., & Alvidrez, J. (2005). Adherence to antidepressant medications in black and Latino elderly patients. The American Journal of Geriatric Psychiatry, 13(7), 572–580.

  • Benbassat, J., Pilpel, D., & Tidhar, M. (1998). Patients’ preferences for participation in clinical decision making: A review of published surveys. Behavioral Medicine, 24(2), 81–88.

  • Carrasquillo, O., Carrasquillo, A. I., & Shea, S. (2000). Health insurance coverage of immigrants living in the United States: differences by citizenship status and country of origin. American Journal of Public Health, 90(6), 917–923.

  • Centers for Disease Control and Prevention (2013). The state of aging and health in America 2013. Centers for Disease Control and Prevention, US Department of Health and Human Services. Atlanta, Georgia. Retrieved from http://www.cdc.gov/features/agingandhealth/state_of_aging_and_health_in_america_2013.pdf

  • Chapa, T. (2004). Mental health services in primary care settings for racial and ethnic minority populations. U.S. Department of Health and Human Services Office. https://minorityhealth.hhs.gov/Assets/pdf/Checked/1/Mental_Health_Services_in_Primary_Care_Settings_for_Racial2004.pdf of Minority Health.

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159.

  • Cordina, M., Hämeen-Anttila, K., Lauri, J., Tabone, S., & Enlund, H. (2018). Health and medication literacy and the desire to participate in pharmacotherapy decision making–comparison of two countries. Research in Social and Administrative Pharmacy, 14(9), 817–823.

  • Crum, R. M., Anthony, J. C., Bassett, S. S., & Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. Journal of the American Medical Association, 269(18), 2386–2391.

  • Dall, T. M., Gallo, P. D., Chakrabarti, R., West, T., Semilla, A. P., & Storm, M. V. (2013). An aging population and growing disease burden will require a large and specialized health care workforce by 2025. Health Affairs, 32, 2013–2020. doi: https://doi.org/10.1377/hlthaff.2013.0714.

  • Dickinson, D., Raynor, D. T., Kennedy, J. G., Bonaccorso, S., & Sturchio, J. L. (2003). Ask the patients—they may want to know more than you think. British Medical Journal, 327(7419), 861.

  • Ende, J., Kazis, L., Ash, A., & Moskowitz, M. A. (1989). Measuring patients’ desire for autonomy. Journal of General Internal Medicine, 4, 23–30. doi: https://doi.org/10.1007/BF02596485.

  • Fishman, P. A., Goodman, M. J., Hornbrook, M. C., Meenan, R. T., Bachman, D. J., & Rosetti, M. C. K. (2003). Risk adjustment using automated ambulatory pharmacy data: The RxRisk model. Medical Care, 41, 84–99.

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

  • Hahm, H. C., Cook, B. L., Ault-Brutus, A., & Alegría, M. (2015). Intersection of race-ethnicity and gender in depression care: Screening, access, and minimally adequate treatment. Psychiatric Services, 66(3), 258–264.

  • Hamilton, M. (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 56–62. doi:https://doi.org/10.1136/jnnp.23.1.56.

  • Institute of Medicine. (2011). Promoting health literacy to encourage prevention and wellness: Workshop summary. Washington, DC: National Academies Press.

  • Jolles, M. P., Richmond, J., & Thomas, K. C. (2019). Minority patient preferences, barriers, and facilitators for shared decision-making with health care providers in the USA: A systematic review. Patient Education and Counseling, 102(7), 1251–1262.

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.

  • Levinson, W., Kao, A., Kuby, A., & Thisted, R. A. (2005). Not all patients want to participate in decision making. Journal of General Internal Medicine, 20, 531–535. Doi: https://doi.org/10.1111/j.1525-1497.2005.04101.x.

  • Matoff-Stepp, S., Applebaum, B., Pooler, J., & Kavanagh, E. (2014). Women as health care decision-makers: Implications for health care coverage in the United States. Journal of Health Care for the Poor and Underserved, 25(4), 1507–1513.

  • Matthews, E. B., Savoy, M., Paranjape, A., Washington, D., Hackney, T., Galis, D., & Zisman-Ilani, Y. (2021). Shared decision making in primary care based depression treatment: communication and decision-making preferences among an underserved patient population. Frontiers in Psychiatry, 12, 12:681165.

  • Narayan, M. C. (2002). The national standards for culturally and linguistically appropriate services in health care. Care Management Journals, 3(2), 77–83.

  • Nelson, A. (2002). Unequal treatment: confronting racial and ethnic disparities in health care. Journal of the National Medical Association, 94(8), 666–668.

  • Olfson, M., Blanco, C., & Marcus, S. C. (2016). Treatment of adult depression in the United States. Journal of the American Medical Association Internal Medicine, 176(10), 1482–1491.

  • Park, S. G., Derman, M., Dixon, L. B., Brown, C. H., Klingaman, E. A., Fang, L. J., & Kreyenbuhl, J. (2014). Factors associated with shared decision–making preferences among veterans with serious mental illness. Psychiatric Services, 65(12), 1409–1413.

  • Park, L. T., & Zarate, C. A. Jr. (2019). Depression in the primary care setting. New England Journal of Medicine, 380(6), 559–568.

  • Patel, S. R., & Bakken, S. (2010). Preferences for participation in decision making among ethnically diverse patients with anxiety and depression. Community Mental Health Journal, 46(5), 466–473.

  • Ramos-Brieva, J. A., & Cordero-Villafafila, A. (1988). A new validation of the Hamilton Rating Scale for Depression. Journal of Psychiatric Research, 22(1), 21–28.

  • Raue, P. J., Schulberg, H. C., Heo, M., Klimstra, S., & Bruce, M. L. (2009). Patients’ depression treatment preferences and initiation, adherence, and outcome: a randomized primary care study. Psychiatric services, 60(3), 337–343.

  • Raue, P. J., Schulberg, H. C., Bruce, M. L., Banerjee, S., Artis, A., Espejo, M., … & Romero, S. (2019). Effectiveness of shared decision-making for elderly depressed minority primary care patients. The American Journal of Geriatric Psychiatry, 27(8), 883-893.

  • Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., & US Preventive Services Task Force. (2016). Screening for depression in adults: US Preventive Services Task Force recommendation statement. The Journal of American Medical Association, 315(4), 380–387.

  • Taylor, W. D. (2014). Depression in the elderly. New England Journal of Medicine, 371(13), 1228–1236.

  • Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., & Oishi, S. (2003). Depression treatment in a sample of 1,801 depressed older adults in primary care. Journal of the American Geriatrics Society, 51, 505–514. Doi: https://doi.org/10.1046/j.1532-5415.2003.51159.x.

  • Vega, W. A., Karno, M., Alegria, M., Alvidrez, J., Bernal, G., Escamilla, M., & Loue, S. (2007). Research issues for improving treatment of US Hispanics with persistent mental disorders. Psychiatric Services, 58(3), 385–394.

  • Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., & Catalano, R. (1999). Gaps in service utilization by Mexican Americans with mental health problems. The American Journal of Psychiatry, 156, 928–934. doi: https://doi.org/10.1176/ajp.156.6.928.

  • Whitfield, K. E., & Baker, T. A. (2013). Handbook of Minority Aging. New York: Springer Publishing Company.

  • Zivin, K., & Kales, H. C. (2008). Adherence to depression treatment in older adults. Drugs & aging, 25(7), 559–571.

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Acknowledgements

Contributors: We would like to acknowledge the CWFFLs. Idalia Catalan, Narolyn Mendes, Dhara Shah, and Tanairi Quezada, the research assistants who collected the data.

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Authors and Affiliations

  1. Harvard Medical School, 641 Huntington Avenue, 02115, Boston, MA, USA

    Sara A. Romero

  2. Fordham University, Bronx, NY, USA

    Andrew Rasmussen

  3. University of Washington Medical Center, Seattle, WA, USA

    Patrick J. Raue

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  1. Sara A. Romero
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  2. Andrew Rasmussen
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Correspondence to Sara A. Romero.

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This research study had grant support from an R-series grant (R01 MH084872). The authors have no relevant financial or non-financial interests to disclose.

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Romero, S.A., Rasmussen, A. & Raue, P.J. Treatment Decision-Making Preferences of Older Depressed Minority Primary Care Patients. Community Ment Health J 59, 719–727 (2023). https://doi.org/10.1007/s10597-022-01055-0

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