Treatment preferences and their determinants among adults with depression or anxiety in out-patient mental healthcare: systematic review

门诊精神卫生保健中抑郁症或焦虑症成年患者的治疗偏好及其决定因素:系统评价

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Abstract

BACKGROUND: Accommodation of treatment preferences is known to improve treatment outcomes and increase patient satisfaction, and is further advised in several national guidelines. AIMS: The aim of this study was to systematically review studies that elicited treatment preferences and related determinants among adults with depressive or anxiety disorder for out-patient mental healthcare. METHOD: The systematic review was registered in PROSPERO (CRD42024546311). Studies were retrieved from Web of Science, PubMed, CINAHL and PsycINFO. We included studies of all types that assessed treatment preferences of adults with depressive or anxiety disorder for out-patient care. Extracted data on preferences and determinants were summarised and categorised. Preferences were categorised into treatment approaches, psychotherapy delivery and setting, and psychotherapy parameters. Study quality was assessed with the Mixed-Methods Appraisal Tool. RESULTS: Nineteen studies were included in the review. Preferences examined related to treatment approaches (n = 13), psychotherapy delivery and setting (n = 10), and psychotherapy parameters (n = 7). High heterogeneity in statistical methods and preference types restricted the derivation of robust conclusions, but tendencies toward a preference for psychotherapy (compared with medication), and particularly individual and face-to-face therapy, were observed. Regarding determinants, results were highly diverse and many findings were derived from single studies. CONCLUSIONS: Our review synthesised evidence on treatment preferences and related determinants in out-patient mental healthcare. Results showed considerable heterogeneity regarding preference types, determinants and statistical methods. We highly recommend to develop and use standardised instruments to assess treatment preferences. Care providers should consider preference variance among patients, and provide individualised care.

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