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The Impact of Patient Preference on Mental Health Treatment: A Methodological Critique and Suggestions for Future Research
Abstract
Objectives: Although mental health guidelines increasingly cite the importance of considering patient treatment preference, the substantial variability in study methodology complicates synthesis of empirical research in this area. The objective of this study was to critically review the methodological designs commonly used to assess the relationship between patient preference and mental health treatment outcome and to provide suggestions for future research.
Methods: This study reviewed and critically evaluated the methods of studies published between 1993 and 2013 in PsychInfo and PubMed that assessed the effect of patient preference on mental health treatment outcome.
Results: A total of 23 studies met inclusion criteria. Most studies (45%) evaluated preference as an added dimension of a randomized clinical trial or used a comprehensive cohort design (35%) wherein patients who refuse randomization can select a preferred treatment. Approximately half of the studies (45%) provided no detail about whether patients received any treatment information prior to preference assessment, and 36% of studies included no detail about how preference was assessed. Most studies focused on depression, indicating that the impact of patient preference remains underexamined in many mental health populations
Conclusions: To date, preference effects have most often been evaluated with designs that are better suited to evaluate treatment effects than preference effects (i.e., randomized controlled trials, comprehensive cohort designs). The methodological limitations identified in the extant literature underscore the need for increased attention to key methodological issues, which can enhance the ability of future studies to meaningfully evaluate the impact of patient preference.
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DOI: http://dx.doi.org/10.5750/ejpch.v3i1.861
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