Open AccessTreatment Preferences Among Depressed Primary Care Patients
Author(s) -
DwightJohnson Megan,
Sherbourne Cathy D.,
Liao Diana,
Wells Kenneth B.
Publication year - 2000
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.2000.08035.x
Subject(s) - medicine , cidi , depression (economics) , confidence interval , odds ratio , epidemiology , center for epidemiologic studies depression scale , primary care , psychiatry , family medicine , depressive symptoms , anxiety , economics , national comorbidity survey , macroeconomics
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.