Annals of Behavioral Medicine

, Volume 30, Issue 2, pp 164–173

The influence of patient preference on depression treatment in primary care

  • Patricia Lin
  • Duncan G. Campbell
  • Edmund F. Chaney
  • Chuan-Fen Liu
  • Patrick Heagerty
  • Bradford L. Felker
  • Susan C. Hedrick
Article

Abstract

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.

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References

  1. (1).
    Wagner EH, Austin BT, Von Korff M: Improving outcomes in chronic illness.Managed Care Quarterly. 1996,4:12–25.PubMedGoogle Scholar
  2. (2).
    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.PubMedGoogle Scholar
  3. (3).
    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.PubMedGoogle Scholar
  4. (4).
    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.PubMedGoogle Scholar
  5. (5).
    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.PubMedCrossRefGoogle Scholar
  6. (6).
    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.PubMedCrossRefGoogle Scholar
  7. (7).
    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.PubMedGoogle Scholar
  8. (8).
    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.PubMedCrossRefGoogle Scholar
  9. (9).
    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.PubMedCrossRefGoogle Scholar
  10. (10).
    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.PubMedCrossRefGoogle Scholar
  11. (11).
    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.PubMedCrossRefGoogle Scholar
  12. (12).
    Cebul RD: Randomized, controlled trials using the metro firm system.Medical Care. 1991,29:JS9-JS18.PubMedGoogle Scholar
  13. (13).
    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.PubMedCrossRefGoogle Scholar
  14. (14).
    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.Google Scholar
  15. (15).
    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.CrossRefGoogle Scholar
  16. (16).
    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.PubMedCrossRefGoogle Scholar
  17. (17).
    Von Korff M, Gruman J, Schaefer J, Curry SJ, Wagner EH: Collaborative management of chronic illness.Annals of Internal Medicine. 1997,127:1097–1102.Google Scholar
  18. (18).
    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.PubMedCrossRefGoogle Scholar
  19. (19).
    Padesky CA, Greenberger D:Clinician’s Guide to Mind Over Mood. New York: Guilford, 1995.Google Scholar
  20. (20).
    Greenberger D, Padesky CA:Mind Over Mood. New York: Guilford, 1995.Google Scholar
  21. (21).
    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.PubMedCrossRefGoogle Scholar
  22. (22).
    Von Korff M, Wagner EH, Saunders K: A chronic disease score from automated pharmacy data.Journal of Clinical Epidemiology. 1992,45:197–203.CrossRefGoogle Scholar
  23. (23).
    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.PubMedCrossRefGoogle Scholar
  24. (24).
    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.PubMedCrossRefGoogle Scholar
  25. (25).
    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.Google Scholar
  26. (26).
    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.Google Scholar
  27. (27).
    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.PubMedCrossRefGoogle Scholar
  28. (28).
    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.PubMedGoogle Scholar
  29. (29).
    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.PubMedCrossRefGoogle Scholar
  30. (30).
    Wolinsky FD, Coe RM, Mosely RR, Homan SM: Veterans’ and Nonveterans’ use of health services: A comparative analysis.Medical Care. 1985,23:1358–1371.PubMedCrossRefGoogle Scholar
  31. (31).
    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.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2005

Authors and Affiliations

  • Patricia Lin
    • 1
  • Duncan G. Campbell
    • 1
  • Edmund F. Chaney
    • 2
    • 3
  • Chuan-Fen Liu
    • 4
  • Patrick Heagerty
    • 5
  • Bradford L. Felker
    • 6
  • Susan C. Hedrick
    • 1
    • 6
  1. 1.Seattle
  2. 2.Department of Health ServicesUniversity of WashingtonUSA
  3. 3.Health Services Research and Development Center of Excellence and Mental Health Service, VA Puget Sound Health Care SystemUSA
  4. 4.Department of Psychiatry and Behavioral SciencesUniversity of WashingtonUSA
  5. 5.Department of Health ServicesUniversity of WashingtonUSA
  6. 6.Mental Health Service VA Puget Sound Health Care SystemUSA

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