학술논문

Are Veterans Getting Their Preferred Depression Treatment? A National Observational Study in the Veterans Health Administration
Document Type
article
Source
Journal of General Internal Medicine. 37(13)
Subject
Health Services and Systems
Biomedical and Clinical Sciences
Clinical Sciences
Health Sciences
Clinical Trials and Supportive Activities
Clinical Research
Depression
Behavioral and Social Science
Mental Health
Serious Mental Illness
Rehabilitation
Brain Disorders
Management of diseases and conditions
7.1 Individual care needs
Mental health
Good Health and Well Being
Female
Humans
Male
Middle Aged
Patient Preference
Psychotherapy
Veterans
Veterans Health
major depression
treatment preferences
treatment adherence
General & Internal Medicine
Clinical sciences
Health services and systems
Public health
Language
Abstract
BackgroundPhysician responsiveness to patient preferences for depression treatment may improve treatment adherence and clinical outcomes.ObjectiveTo examine associations of patient treatment preferences with types of depression treatment received and treatment adherence among Veterans initiating depression treatment.DesignPatient self-report surveys at treatment initiation linked to medical records.SettingVeterans Health Administration (VA) clinics nationally, 2018-2020.ParticipantsA total of 2582 patients (76.7% male, mean age 48.7 years, 62.3% Non-Hispanic White) MAIN MEASURES: Patient self-reported preferences for medication and psychotherapy on 0-10 self-anchoring visual analog scales (0="completely unwilling"; 10="completely willing"). Treatment receipt and adherence (refilling medications; attending 3+ psychotherapy sessions) over 3 months. Logistic regression models controlled for socio-demographics and geographic variables.Key resultsMore patients reported strong preferences (10/10) for psychotherapy than medication (51.2% versus 36.7%, McNemar χ21=175.3, p