Patient preferences for treatment of major depressive disorder and the impact on health outcomes: a systematic review.
Patient preferences for treatment of major depressive disorder and the impact on health outcomes: a systematic review.
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DOI：
10.4088/pcc.11r01161
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发表时间：
2011-01-01
影响因子：
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通讯作者：
Classi, Peter M
中科院分区：
文献类型：
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作者：
Gelhorn, Heather L;Sexton, Chris C;Classi, Peter M
目的：为了总结抑郁症治疗的患者偏好和这些偏好对treatment.DATA的结果的影响同行评议的文献：研究通过系统的搜索同时进行PsycINFO和MEDLINE使用EBSCOhost和EMBASE。文献检索时间为2010年3月。研究选择：检索词包括抑郁症或抑郁症或重性抑郁障碍、患者偏好、治疗偏好、干预偏好和药物治疗偏好。对出版年限没有限制。资料提炼：15篇文章包含了关于患者对抑郁症治疗的偏好及其对抑郁症相关结果的影响的独特信息。结果：患者偏好文献包括有限数量的研究，研究患者偏好对结果的影响，如抑郁症严重程度、治疗开始、持续性和依从性、治疗参与，治疗联盟的发展和与健康有关的生活质量。大多数偏好研究都集中在心理治疗与药物治疗的比较上，关于心理治疗比较的信息有限。迄今为止的研究结果表明，患者治疗偏好的影响是混合的。结果还表明，在对照临床试验的背景下，患者的偏好对抑郁症严重程度的影响最小，但可能与其他结果（如进入治疗和治疗联盟的发展）更密切相关。然而，重要的是要注意，文献是有限的，患者偏好的影响已被检查，只有通过二次分析，并有一些研究明确设计，以检查患者的偏好的影响，特别是在对照临床试验的背景之外。CONCLUSIONS：考虑患者的偏好抑郁症治疗可能会导致增加治疗启动和改善治疗联盟。然而，尽管在文献中的治疗指南和建议，在现实世界的治疗决策中考虑患者偏好的价值和适当的程序值得更仔细的研究。需要进一步的研究，未来的研究应该在更自然的治疗环境中进行，检查患者对其他特定抑郁症治疗方法的偏好，包括与个体药物治疗和第二步治疗比较相关的偏好。
OBJECTIVE: To summarize the peer-reviewed literature on patient preferences for depression treatments and the impact of these preferences on the outcomes of treatment.DATA SOURCES: Studies were identified via a systematic search conducted simultaneously in PsycINFO and MEDLINE using EBSCOhost and EMBASE. Publications were retrieved in March 2010.STUDY SELECTION: Search terms included depression OR MDD OR major depressive disorder, patient preference, treatment preference, intervention preference, and pharmacotherapy preference. There were no restrictions on years of publication. The search was restricted to research articles written in English.DATA EXTRACTION: Fifteen articles contained unique information on patient preferences for depression treatments and their impact on depression-related outcomes.RESULTS: The patient preference literature includes a limited number of studies examining the impact of patient preferences on outcomes such as depression severity, treatment initiation, persistence and adherence, treatment engagement, the development of the therapeutic alliance, and health-related quality of life. The majority of the preference research has focused on comparisons of psychotherapy versus pharmacotherapy, with some limited information regarding comparisons of psychotherapies. Results from the research to date suggest that the impact of patient treatment preferences is mixed. The results also indicate that patient preferences have minimal impact on depression severity outcomes within the context of controlled clinical trials but may be more strongly associated with other outcomes such as entry into treatment and development of the therapeutic alliance. However, it is important to note that the literature is limited in that the impact of patient preference has been examined only through secondary analyses, and there have been few studies designed explicitly to examine the impact of patient preferences, particularly outside the context of controlled clinical trials.CONCLUSIONS: Consideration of patient preferences for depression treatments may lead to increased treatment initiation and improved therapeutic alliance. However, despite treatment guidelines and suggestions in the literature, the value of and appropriate procedures for considering patient preferences in real-world treatment decisions deserves more careful study. Further research is needed, and future studies should be conducted in more naturalistic treatment settings that examine patient preferences for other specific approaches to depression treatments including preferences related to comparisons of individual pharmacotherapies and second-step treatments.