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What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders

Journal Article


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Abstract


  • Objective: To investigate patients’ preferences for

    outcomes associated with psychoactive medications.

    Setting/design: Systematic review of stated

    preference studies. No settings restrictions were

    applied.

    Participants/eligibility criteria: We included

    studies containing quantitative data regarding the

    relative value adults with mental disorders place on

    treatment outcomes. Studies with high risk of bias

    were excluded.

    Primary and secondary outcome measures: We

    restricted the scope of our review to preferences for

    outcomes, including the consequences from, attributes

    of, and health states associated with particular

    medications or medication classes, and process

    outcomes.

    Results: After reviewing 11 215 citations, 16 studies

    were included in the systematic review. These studies

    reported the stated preferences from patients with

    schizophrenia (n=9), depression (n=4), bipolar disorder

    (n=2) and attention deficit hyperactive disorder (n=1).

    The median sample size was 81. Side effects and

    symptom outcomes outnumbered functioning and

    process outcomes. Severe disease and hospitalisation

    were reported to be least desirable. Patients with

    schizophrenia tended to value disease states as higher

    and side effects as lower, compared to other

    stakeholder groups. In depression, the ability to cope

    with activities was found to be more important than a

    depressed mood, per se. Patient preferences could not

    consistently be predicted from demographic or disease

    variables. Only a limited number of potentially

    important outcomes had been investigated. Benefits to

    patients were not part of the purpose in 9 of the 16

    studies, and in 10 studies patients were not involved

    when the outcomes to present were selected.

    Conclusions: Insufficient evidence exists on the

    relative value patients with mental disorders place on

    medication-associated outcomes. To increase patientcentredness

    in decisions involving psychoactive drugs,

    further research—with outcomes elicited from patients,

    and for a larger number of conditions—should be

    undertaken.

UOW Authors


  •   Eiring, Oystein (external author)
  •   Landmark, Brynjar (external author)
  •   Aas, Endre (external author)
  •   Salkeld, Glenn
  •   Nylenna, Magne (external author)
  •   Nytrøen, Kari (external author)

Publication Date


  • 2015

Citation


  • Eiring, O., Landmark, B. F., Aas, E., Salkeld, G., Nylenna, M. & Nytroen, K. (2015). What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders. BMJ Open, 5 (4), e007848-1-e007848-14.

Scopus Eid


  • 2-s2.0-84929337794

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=3634&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/2632

Has Global Citation Frequency


Start Page


  • e007848-1

End Page


  • e007848-14

Volume


  • 5

Issue


  • 4

Place Of Publication


  • United Kingdom

Abstract


  • Objective: To investigate patients’ preferences for

    outcomes associated with psychoactive medications.

    Setting/design: Systematic review of stated

    preference studies. No settings restrictions were

    applied.

    Participants/eligibility criteria: We included

    studies containing quantitative data regarding the

    relative value adults with mental disorders place on

    treatment outcomes. Studies with high risk of bias

    were excluded.

    Primary and secondary outcome measures: We

    restricted the scope of our review to preferences for

    outcomes, including the consequences from, attributes

    of, and health states associated with particular

    medications or medication classes, and process

    outcomes.

    Results: After reviewing 11 215 citations, 16 studies

    were included in the systematic review. These studies

    reported the stated preferences from patients with

    schizophrenia (n=9), depression (n=4), bipolar disorder

    (n=2) and attention deficit hyperactive disorder (n=1).

    The median sample size was 81. Side effects and

    symptom outcomes outnumbered functioning and

    process outcomes. Severe disease and hospitalisation

    were reported to be least desirable. Patients with

    schizophrenia tended to value disease states as higher

    and side effects as lower, compared to other

    stakeholder groups. In depression, the ability to cope

    with activities was found to be more important than a

    depressed mood, per se. Patient preferences could not

    consistently be predicted from demographic or disease

    variables. Only a limited number of potentially

    important outcomes had been investigated. Benefits to

    patients were not part of the purpose in 9 of the 16

    studies, and in 10 studies patients were not involved

    when the outcomes to present were selected.

    Conclusions: Insufficient evidence exists on the

    relative value patients with mental disorders place on

    medication-associated outcomes. To increase patientcentredness

    in decisions involving psychoactive drugs,

    further research—with outcomes elicited from patients,

    and for a larger number of conditions—should be

    undertaken.

UOW Authors


  •   Eiring, Oystein (external author)
  •   Landmark, Brynjar (external author)
  •   Aas, Endre (external author)
  •   Salkeld, Glenn
  •   Nylenna, Magne (external author)
  •   Nytrøen, Kari (external author)

Publication Date


  • 2015

Citation


  • Eiring, O., Landmark, B. F., Aas, E., Salkeld, G., Nylenna, M. & Nytroen, K. (2015). What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders. BMJ Open, 5 (4), e007848-1-e007848-14.

Scopus Eid


  • 2-s2.0-84929337794

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=3634&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/2632

Has Global Citation Frequency


Start Page


  • e007848-1

End Page


  • e007848-14

Volume


  • 5

Issue


  • 4

Place Of Publication


  • United Kingdom