Treatment Preferences Among Depressed Primary Care Patients
Article first published online: 25 DEC 2001
Journal of General Internal Medicine
Volume 15, Issue 8, pages 527–534, August 2000
How to Cite
Dwight-Johnson, M., Sherbourne, C. D., Liao, D. and Wells, K. B. (2000), Treatment Preferences Among Depressed Primary Care Patients. Journal of General Internal Medicine, 15: 527–534. doi: 10.1046/j.1525-1497.2000.08035.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- primary care;
- patient preferences;
- treatment preferences
OBJECTIVE: To understand patient factors that may affect the probability of receiving appropriate depression treatment, we examined treatment preferences and their predictors among depressed primary care patients.
DESIGN: Patient questionnaires and interviews.
SETTING: Forty-six primary care clinics in 7 geographic regions of the United States.
PARTICIPANTS: One thousand one hundred eighty-seven English- and Spanish-speaking primary care patients with current depressive symptoms.
MEASUREMENTS AND MAIN RESULTS: Depressive symptoms and diagnoses were determined by the Composite International Diagnostic Interview (CIDI) and the Center for Epidemiological Studies Depression Scale (CES-D). Treatment preferences and characteristics were assessed using a self-administered questionnaire and a telephone interview. Nine hundred eight-one (83%) patients desired treatment for depression. Those who preferred treatment were wealthier (odds ratio [OR], 3.7; 95% confidence interval [95% CI], 1.8 to 7.9; P = .001) and had greater knowledge about antidepressant medication ( OR, 2.6; 95% CI, 1.6 to 4.4; P≤ .001) than those who did not want treatment. A majority ( 67%, n = 660) of those preferring treatment preferred counseling, with African Americans (OR, 2.2; 95% CI, 1.0 to 4.8, P = .04 compared to whites) and those with greater knowledge about counseling (OR, 2.1; 95% CI, 1.6 to 2.7, P≤ .001) more likely to choose counseling. Three hundred twelve ( 47%) of the 660 desiring counseling preferred group over individual counseling. Depression severity was only a predictor of preference among those already in treatment.
CONCLUSIONS: Despite low rates of treatment for depression, most depressed primary care patients desire treatment, especially counseling. Preferences for depression treatment vary by ethnicity, gender, income, and knowledge about treatments.