Eliciting Depression Patients' Preferences for Medication Management: A Protocol for Discrete Choice Experiment

Area of Science:

• Psychiatry and Behavioral Sciences
• Health Economics
• Health Services Research

Background:

• Depression significantly impacts lives and incurs economic costs, with patient adherence to antidepressant medication being critical for successful management.
• Poor adherence leads to treatment failure and adverse clinical outcomes, highlighting the need to incorporate patient preferences into treatment decisions.
• Discrete Choice Experiments (DCE) are valuable tools for quantifying patient preferences, yet previous studies often overlook factors beyond the medication itself.

Purpose of the Study:

• To explore medication-management-related characteristics influencing antidepressant adherence in depression patients.
• To elicit how depression patients perceive and weigh trade-offs between different medication management strategies.
• To inform patient-centered approaches for improving depression treatment adherence.

Main Methods:

• A Discrete Choice Experiment (DCE) was designed, involving six attributes and their levels, developed through literature reviews, interviews, and focus groups.
• A fractional factorial design generated 36 choice sets, divided into 3 blocks for analysis.
• A mixed logit model will be employed to analyze patient preferences, willingness to pay, and uptake rates for various medication management attributes.

Main Results:

• The study outlines a systematic and rigorous development process for the DCE, adhering to theoretical foundations and design principles.
• Pilot testing confirmed the questionnaire's clarity and suitability for formal surveys, comprising an introduction, sociodemographic questions, and 13 DCE choice sets with an opt-out option.
• The methodology is established for exploring patient preferences in medication management, paving the way for future quantitative analysis.

Conclusions:

• This study demonstrates a robust framework for conducting and reporting DCE research in the context of depression treatment adherence.
• The findings will contribute to a better understanding of patient preferences, enabling the development of more effective and personalized antidepressant management strategies.
• By systematically exploring patient trade-offs, this research aims to enhance medication adherence and improve clinical outcomes for individuals with depression.