The influence of patient preference on depression treatment in primary care
The influence of patient preference on depression treatment in primary care
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DOI：
10.1207/s15324796abm3002_9
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发表时间：
2005-10-01
影响因子：
3.8
通讯作者：
Hedrick, SC
中科院分区：
文献类型：
--
作者：
Lin, P;Campbell, DG;Hedrick, SC
背景：慢性病模型鼓励考虑患者的治疗偏好。此外，研究表明，将治疗与偏好相匹配可能会影响抑郁症患者的预后。目的：探讨治疗偏好匹配的相关因素及其对抑郁症治疗结果的影响。方法：对参与抑郁症管理的大型随机试验的初级保健抑郁症患者的治疗偏好进行评估。根据偏好和其他几个因素，为患者提供抗抑郁药物和/或咨询。在3个月和9个月时进行抑郁评估。结果：倾向于服药的参与者年龄较大，身体健康状况较差，而且更有可能已经在服用抗抑郁药。同时喜欢药物治疗和心理咨询的参与者更同意抑郁症是一种医学疾病的说法。总体而言，72%的参与者与他们喜欢的治疗方法相匹配；匹配的参与者比未匹配的参与者表现出更快的抑郁症状改善。结论：获得首选治疗似乎有助于改善治疗结果。继续尝试评估和适应治疗偏好可能会导致对抑郁症治疗的更好反应。
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.