DETERMINING WHO NEEDS TAILORED DEPRESSION CARE: THE VALUES MARKERS STUDY

Tuesday, October 26, 2010
Sheraton Hall E/F (Sheraton Centre Toronto Hotel)
Marsha Wittink, MD, MBE, Mark Cary, Ph.D. and Steven Lucas, University of Pennsylvania School of Medicine, Philadelphia, PA

Purpose: To asses the relationship between patterns of valued treatment attributes (“values markers”) and depression treatment uptake in order to determine who may need a tailored treatment approach to improve treatment initiation and adherence.

Method: Primary care patients with depressive symptoms were offered a choice of depression treatment (medication and/or counseling) and followed over 12 weeks. At baseline all patients were given a discrete-choice task to determine the depression treatment attributes (mechanism of action, time treatment takes to have an effect, and type of side-effect) they most prefer. Latent profile analysis was used to identify patterns of treatment attributes (values markers) within the sample. We then assessed the association between values makers and initiation and adherence to the depression treatment chosen.

Result: Preliminary results suggest that there are three profiles sexual weight and sleep dysfunction side-effects. A second profile prefers treatments that avoid a chemical or biological mechanism of action but were more willing to accept treatments with sexual, weight and sleep dysfunction. A third profile consists of preferring treatments that work through giving you coping methods and have some immediate helping effects. Patients in the third profile may be more likely to have chosen counseling. We are in the process of collecting and analyzing more data and will have further results, including information related to adherence to treatment, to discuss by the time of the meeting. 

Conclusion: Latent profile analysis based on discrete choice data can provide important insights into which patients (based on “values markers”) will initiate and adhere to standard depression treatment and which patients might benefit from a tailored approach to treatment that is more in line with the types of treatment attributes they value most.