title: What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders.
abstract: OBJECTIVE
  To investigate patients' preferences for outcomes associated with psychoactive medications.
  
  
  METHODS
  Systematic review of stated preference studies. No settings restrictions were applied.
  We included studies containing quantitative data regarding the relative value adults with mental disorders place on treatment outcomes. Studies with high risk of bias were excluded.
  
  
  METHODS
  We restricted the scope of our review to preferences for outcomes, including the consequences from, attributes of, and health states associated with particular medications or medication classes, and process outcomes.
  
  
  RESULTS
  After reviewing 11 215 citations, 16 studies were included in the systematic review. These studies reported the stated preferences from patients with schizophrenia (n=9), depression (n=4), bipolar disorder (n=2) and attention deficit hyperactive disorder (n=1). The median sample size was 81. Side effects and symptom outcomes outnumbered functioning and process outcomes. Severe disease and hospitalisation were reported to be least desirable. Patients with schizophrenia tended to value disease states as higher and side effects as lower, compared to other stakeholder groups. In depression, the ability to cope with activities was found to be more important than a depressed mood, per se. Patient preferences could not consistently be predicted from demographic or disease variables. Only a limited number of potentially important outcomes had been investigated. Benefits to patients were not part of the purpose in 9 of the 16 studies, and in 10 studies patients were not involved when the outcomes to present were selected.
  
  
  CONCLUSIONS
  Insufficient evidence exists on the relative value patients with mental disorders place on medication-associated outcomes. To increase patient-centredness in decisions involving psychoactive drugs, further research-with outcomes elicited from patients, and for a larger number of conditions-should be undertaken.
  
  
  BACKGROUND
  PROSPERO CRD42013005685.
authors: Faculty of Medicine, University of Oslo, Oslo, Norway Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
authors: Øystein
authors: Ø
authors: Eiring
authors: Department of Quality and Patient Safety, Innlandet Hospital Trust, Brumunddal, Norway.
authors: Brynjar Fowels
authors: BF
authors: Landmark
authors: Department of Quality and Patient Safety, Innlandet Hospital Trust, Brumunddal, Norway.
authors: Endre
authors: E
authors: Aas
authors: University of Sydney, School of Public Health, Sydney, Australia.
authors: Glenn
authors: G
authors: Salkeld
authors: Faculty of Medicine, University of Oslo, Oslo, Norway Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
authors: Magne
authors: M
authors: Nylenna
authors: Faculty of Medicine, University of Oslo, Oslo, Norway Department of Quality and Patient Safety, Innlandet Hospital Trust, Brumunddal, Norway.
authors: Kari
authors: http://orcid.org/0000-0002-4827-4700
authors: K
authors: Nytrøen
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D057240:Patient Preference; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs
keywords: MENTAL HEALTH; PSYCHIATRY