The influence of patient preference on depression treatment in primary care.
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.


OBJECTIVE
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.
Lin
Patricia
P
Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, WA 98108, USA.
Campbell
Duncan G
DG
Chaney
Edmund F
EF
Liu
Chuan-Fen
CF
Heagerty
Patrick
P
Felker
Bradford L
BL
Hedrick
Susan C
SC
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003299:Cooperative Behavior; D003376:Counseling / Q000706:statistics & numerical data; D003695:Delivery of Health Care; D003863:Depression / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011613:Psychotherapy / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis
D000928:Antidepressive Agents