A new study points to differences in priorities between patients and clinicians when deciding on treatment for depression.1 Patients and clinicians agreed on several top priorities when making a decision about how to treat depression: effectiveness of treatment, side effects, and speed of recovery. However, there were also several differences. Patients placed greater priority on treatment costs and insurance coverage. Providers placed higher priority on explanations of how a treatment should be used and how it works.
The survey, led by researchers from the Dartmouth School Institute of Health Policy and Clinical Practice, included nearly 1,000 U.S. adults who were being treated, were awaiting treatment, or had previously been treated for depression. Researchers also surveyed nearly 250 clinicians, including psychiatrists, primary care doctors, and therapists, who had recently treated patients for depression. Both patients and clinicians were asked to rate the information that they believed was most important when choosing a depression treatment.
The study authors note that while some may people contend that medical decision should be based solely on needs, the cost of treatment does have a direct impact. Costs can impact consumer well-being, financial stability, likelihood of sticking with treatment and, ultimately, health status and outcome.
Patients and providers expressed similar concerns related to side effects of treatment; however, patients included sleep problems and increased stress related to treatment among their high priorities.
The researchers also looked at the level of collaboration in decision making between patients and providers. Substantial previous research has found that shared decision making for people with depression leads to people sticking with treatment longer, being more satisfied with treatment, and having improved outcomes.2
Despite the benefits of shared decision making, a number of obstacles exist for patients and their physicians. 2 For example, patients may not see the need to participate or may feel the doctor should be making decisions and some mental health conditions may make it difficult to participate in decision-making. Physicians may feel they don’t have the time to devote to shared decision-making or may feel it is not appropriate in some critical situations.
To learn more about what you can do to improve your treatment for depression, see tips on Working with a Provider and Preparing for Appointments from Mental Health America. Also see more information on Shared Decision Making from the SAMHSA-HRSA Center for Integrated Health Solutions.