Preferences for Treatments for Major Depressive Disorder: Formative Qualitative Research Using the Patient Experience

Susan dosReis (), Laura M. Bozzi, Beverly Butler, Richard Z. Xie, Richard H. Chapman, Jennifer Bright, Erica Malik and Julia F. Slejko
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Susan dosReis: University of Maryland Baltimore
Laura M. Bozzi: University of Maryland Baltimore
Beverly Butler: PAVE Center
Richard Z. Xie: Innovation and Value Initiative
Richard H. Chapman: Innovation and Value Initiative
Jennifer Bright: Innovation and Value Initiative
Erica Malik: Innovation and Value Initiative
Julia F. Slejko: University of Maryland Baltimore

The Patient: Patient-Centered Outcomes Research, 2023, vol. 16, issue 1, No 7, 57-66

Abstract: Abstract Objectives The goals of this formative research are to elicit attributes of treatment and desired outcomes that are important to individuals with major depressive disorder (MDD), to develop a stated preference instrument, and to pre-test the instrument. Methods A three-phase survey study design elicited the patient’s journey with MDD to design and pre-test the discrete choice experiment (DCE) instrument. Participants were 20 adults aged ≥ 18 with MDD who did not also have bipolar disorder or post-partum depression. We engaged patient advocates and a multi-disciplinary stakeholder advisory group to select and refine attributes for inclusion in a DCE instrument. The DCE was incorporated into a survey that also collected depression treatment and management and sociodemographic characteristics. The DCE was pre-tested with ten adults with MDD. Results Six attributes were included in the DCE: mode of treatment (medicine only, psychotherapy only, all modalities including brain stimulation), time to treatment effect (6, 9, 12 weeks), days of hopefulness (2, 4, 6 days/week), effect on productivity (40%, 60%, 90% increase), relations with others (strained, improved, no impact), and out-of-pocket costs ($30, $60, $90/month). The DCE test led to the refinement of mode of treatment (medicine, medicine and psychotherapy, and all modalities); time to treatment effect (4, 6, 9 weeks); monthly out-of-pocket costs ($30, $90, $270). Conclusions MDD treatment preferences revealed trade-offs among mode of treatment, time to treatment effect, functional outcomes, and cost. The findings demonstrate the potential for meaningfully incorporating the patient experience in preference measures.

Date: 2023
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DOI: 10.1007/s40271-022-00596-6

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