title: Towards personalizing treatment for depression : developing treatment values markers.
abstract: BACKGROUND
  While 'personalized medicine' commonly refers to genetic markers or profiles associated with pharmacological treatment response, tailoring treatments to patient preferences and values is equally important.
  
  
  OBJECTIVE
  To describe and demonstrate a method to develop 'values markers,' or profiles based on the relative importance of attributes of depression treatment.
  
  
  METHODS
  Discrete choice analysis was used to assess individuals' relative preferences for features of depression treatment. Preference profiles were developed using latent profile analysis.
  
  
  METHODS
  Eighty-six adults participating in an internet-based discrete choice questionnaire.
  
  
  METHODS
  Participants were presented with two depression scenarios representing mild and severe depression. For each scenario, they were asked to compare 18 choice sets based on the type of medication side effect (nausea, dizziness, and sexual dysfunction) and severity (mild, moderate, and severe); and for counseling frequency (once per week or every other week) and provider setting (the office of a mental health professional, primary care doctor, or spiritual counselor).
  
  
  RESULTS
  Three profiles were identified: profile 1 was associated with a preference for counseling and an avoidance of medication side effects; profile 2 with an avoidance of strong medication side effects and for receiving counseling in medical settings; and profile 3 with a preference for medication over counseling. When presented with a severe depression scenario, there was a higher prevalence for profile 1 and patients were more likely to prefer mental health over primary care and spiritual settings.
  
  
  CONCLUSIONS
  Values markers may provide a foundation for personalized medicine, and reflect current initiatives emphasizing patient-centered care. Next steps should assess whether values markers are predictive of treatment initiation and adherence.
authors: Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. marsha_wittink@URMC.Rochester.edu
authors: Marsha N
authors: MN
authors: Wittink
authors: Knashawn H
authors: KH
authors: Morales
authors: Mark
authors: M
authors: Cary
authors: Joseph J
authors: JJ
authors: Gallo
authors: Stephen J
authors: SJ
authors: Bartels
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003376:Counseling; D003863:Depression / Q000523:psychology* / Q000628:therapy*; D037001:Directive Counseling; D006801:Humans; D010349:Patient Compliance / Q000523:psychology; D057240:Patient Preference; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011159:Population Surveillance; D057285:Precision Medicine / Q000379:methods*; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents