Factors That Impact Treatment Decisions: Results From an Online Survey of Individuals With Bipolar and Unipolar Depression
Abstract
OBJECTIVE: To identify patient-reported factors that influence medication treatment decisions among individuals with bipolar and unipolar depression. METHODS: The Depression and Bipolar Support Alliance (DBSA) conducted an online survey February 2016 to April 2016 asking participants about factors that influence treatment decisions (eg, starting and stopping specific medications). RESULTS: In total, 896 participants completed the survey (49.9% unipolar depression [n = 447] and 50.1% bipolar depression [n = 449]). The majority of respondents reported several previous medication trials. The most frequently reported factors impacting treatment decisions were side effects, doctor recommendations, cost, and how quickly the treatment will begin to work. The most common reason for changing treatments was ineffectiveness in the unipolar depression group and side effects in the bipolar depression group. Weight gain was the side effect that most commonly led respondents to discontinue a medication. When respondents currently using medications versus respondents not using medications were compared, doctor recommendations were more likely to be influential for those taking medications (P < .0001). Conversely, cost (P = .008) and impact on pregnancy/lactation (P = .045) were more likely to impact treatment decisions in participants not currently taking medications. Current medication use was associated with increased rates of perceived treatment effectiveness (P < .0001). CONCLUSIONS: Side effects, doctor recommendations, cost, and rapidity of antidepressant effects were determined to be particularly important factors in making treatment decisions, with doctor recommendations being more influential for medication users and cost being more influential for participants not using medications. These findings highlight the importance of patient-centered factors in adjudicating treatment decisions.
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Evidence indicates that a reduction in depressive symptoms may not be the single most important outcome to patients, but rather factors such as the ability to participate in everyday activities and return to work.
“Importantly, evidence indicates that a reduction in depressive symptoms may not be the single most important outcome to patients, but rather factors such as the ability to participate in everyday activities and return to work.63 64”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [64]
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- Authors
- Rosenblat, J. D., Simon, G. E., Sachs, G. S., Deetz, I., Doederlein, A., DePeralta, D., Dean, M. M., & McIntyre, R. S.
- Affiliations
- University Health Network (CA)
- Kaiser Permanente (US)
- Corresponding author
- McIntyre, Roger S.
- Venue
- The Primary Care Companion For CNS Disorders
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2018-11-01
- Volume
- 20
- Issue
- 6
- ISSN
- 2155-7772 (ISSN-L)
- 2155-7780
- OpenAlex
- W2898833496
- Cited by
- 10
- References
- 0
- Citations by year
- 2024: 3 · 2022: 1 · 2021: 3 · 2019: 3
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Primary Care Companion For CNS Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- treatment decision-making, bipolar depression, major depressive disorder, antidepressants, adverse drug reactions, weight gain, drug costs, physician recommendations, perceived treatment effectiveness, patient-centered care, drug discontinuation, pregnancy and lactation
- MeSH terms
- Antidepressive Agents, Bipolar Disorder, Decision Making, Major Depressive Disorder, Humans, Patient Acceptance of Health Care, Internet, Self Report
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