Preferences for Treatments for Major Depressive Disorder: Formative Qualitative Research Using the Patient Experience

• Published in: The patient : patient-centered outcomes research Vol. 16; no. 1; pp. 57 - 66
• Main Authors: dosReis, Susan, Bozzi, Laura M., Butler, Beverly, Xie, Richard Z., Chapman, Richard H., Bright, Jennifer, Malik, Erica, Slejko, Julia F.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.01.2023; Springer Nature B.V
• Subjects: Adult; Antidepressants; Bipolar disorder; Choice Behavior; Coronaviruses; COVID-19; Decision making; Depressive Disorder, Major - therapy; Electroconvulsive therapy; Health Administration; Health Economics; Humans; Interviews; Literature reviews; Medical research; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Original; Original Research Article; Patient Outcome Assessment; Patient Preference; Pharmacoeconomics and Health Outcomes; Postpartum depression; Preferences; Psychotherapy; Public Health; Qualitative Research; Quality of Life Research; Social impact; Stakeholders; Surveys and Questionnaires
• ISSN: 1178-1653; 1178-1661
• DOI: 10.1007/s40271-022-00596-6

Objectives The goals of this formative research are to elicit attributes of treatment and desired outcomes that are important to individuals with major depressive disorder (MDD), to develop a stated preference instrument, and to pre-test the instrument. Methods A three-phase survey study design elicited the patient’s journey with MDD to design and pre-test the discrete choice experiment (DCE) instrument. Participants were 20 adults aged ≥ 18 with MDD who did not also have bipolar disorder or post-partum depression. We engaged patient advocates and a multi-disciplinary stakeholder advisory group to select and refine attributes for inclusion in a DCE instrument. The DCE was incorporated into a survey that also collected depression treatment and management and sociodemographic characteristics. The DCE was pre-tested with ten adults with MDD. Results Six attributes were included in the DCE: mode of treatment (medicine only, psychotherapy only, all modalities including brain stimulation), time to treatment effect (6, 9, 12 weeks), days of hopefulness (2, 4, 6 days/week), effect on productivity (40%, 60%, 90% increase), relations with others (strained, improved, no impact), and out-of-pocket costs ($30, $60, $90/month). The DCE test led to the refinement of mode of treatment (medicine, medicine and psychotherapy, and all modalities); time to treatment effect (4, 6, 9 weeks); monthly out-of-pocket costs ($30, $90, $270). Conclusions MDD treatment preferences revealed trade-offs among mode of treatment, time to treatment effect, functional outcomes, and cost. The findings demonstrate the potential for meaningfully incorporating the patient experience in preference measures.