Public preferences for counseling regarding antidepressant use during pregnancy: a discrete choice experiment

Counseling about medication safety during pregnancy is delivered inconsistently. The objectives were to determine public preferences and willingness to pay (WTP) for attributes of counseling regarding antidepressant use during pregnancy. Attributes reflected counseling via a telephone Teratology Information Service (TIS) or a visit to a general practitioner (GP).

A discrete choice survey was conducted with volunteers recruited from the general public. Stated preferences and WTP for teratology counseling were described by six attributes: training of information provider (IP), method of contact, knowing the IP, confidence in the IP, helpfulness of information, and cost. Interactions of preferences with participant characteristics were examined.

Of 175 participants, 85% were women and 91% had some college or university education. All attributes had a significant effect on choice. The most important attribute was the helpfulness of information received (WTP C$59 for very helpful information). Counseling via telephone by a trained specialist was preferred, as in a TIS. It was preferred, however, to speak with a provider known to the user (WTP C$43) which is common in a GP setting. Maximum willingness to pay for very helpful information was less for respondents with less education. Respondents who stated that an antidepressant exposure would make them anxious about the pregnancy were willing to pay more for all attributes.

The results suggest that TIS is the preferred model for counseling regarding to antidepressant use during pregnancy. The public valued information that was helpful and preferred receiving information in nontraditional formats; however, familiarity with the provider was important.