Patient preferences for outcomes of depression treatment in Germany: A choice-based conjoint analysis study

Abstract Background In general, treatment efficacy in depressed patients is evaluated mainly based on the core symptoms of depression. However, patients might consider different outcomes. This study used choice-based conjoint analysis (CBC) to evaluate patient preferences for depression treatment ou...

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Bibliographic Details
Published in:	Journal of affective disorders Vol. 148; no. 2; pp. 210 - 219
Main Authors:	Zimmermann, Thomas M, Clouth, Johannes, Elosge, Michael, Heurich, Matthias, Schneider, Edith, Wilhelm, Stefan, Wolfrath, Anette
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier B.V 01-06-2013 Elsevier
Subjects:	Adult Adult and adolescent clinical studies Antidepressants Antidepressive Agents - therapeutic use Bayes Theorem Biological and medical sciences Choice Behavior Choice-based conjoint analysis Depression Depression - complications Depression - drug therapy Discrete choice analysis Female Germany Humans Male Medical sciences Middle Aged Mood disorders Moods Neuropharmacology Pain Pain - etiology Patient Preference - psychology Patient Preference - statistics & numerical data Patient preferences Pharmacology. Drug treatments Psychiatry Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Qualitative Research Side effects Sleep problems Treatment Outcome Treatment preferences Young Adult Europe Germany Patient preferences Depression Antidepressants Choice-based conjoint analysis Discrete choice analysis Mood disorder Human Choice Treatment Preference Psychotropic Antidepressant agent
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Summary:	Abstract Background In general, treatment efficacy in depressed patients is evaluated mainly based on the core symptoms of depression. However, patients might consider different outcomes. This study used choice-based conjoint analysis (CBC) to evaluate patient preferences for depression treatment outcomes. Methods Adult subjects from Germany, currently or previously on antidepressant treatment, were presented with 18 pairs of hypothetical treatment outcome scenarios, differing in eight attributes (2–3 factor levels each): depressed mood, loss of interest and enjoyment, loss of energy/fatigue, sleep disturbance, feelings of guilt, depression-related pain, treatment duration, side effects after 2 weeks. Attributes and factor levels were defined by literature review, expert consultations, and in-depth subject interviews. Data were analyzed using multinomial logit modeling; individual part-worth utilities were estimated using hierarchical Bayes routines. Results Two hundred twenty-seven subjects (89.4% currently treated with antidepressants, 30.0% with depression-related pain) completed the survey. They valued the relative importance of outcomes as follows: loss of energy/fatigue 18.5%, side effects after 2 weeks 14.2%, loss of interest and enjoyment 13.5%, depression-related pain 12.0%, sleep disturbance 12.0%, feelings of guilt 11.5%, treatment duration 9.9%, depressed mood 8.5%. Limitations Participants were not required to meet ICD-10 or DSM-IV criteria for depression and had heterogeneous disease severity. Conclusions CBC analysis was able to reveal patient preferences for outcomes of depression treatment. Subjects valued the ability to cope with activities of everyday living highest. They considered being free of depression-related pain and side effects more important than being free of depressed mood. These findings should be considered when making treatment decisions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0165-0327 1573-2517
DOI:	10.1016/j.jad.2012.11.062