Patient preferences for a guided self-help programme to prevent relapse in anxiety or depression: A discrete choice experiment

PLoS One. 2019 Jul 18;14(7):e0219588. doi: 10.1371/journal.pone.0219588. eCollection 2019.

Abstract

Background: Anxiety and depressive disorders are increasingly being viewed as chronic conditions with fluctuating symptom levels. Relapse prevention programmes are needed to increase self-management and prevent relapse. Fine-tuning relapse prevention programmes to the needs of patients may increase uptake and effectiveness.

Materials and methods: A discrete choice experiment (DCE) was conducted amongst patients with a partially or fully remitted anxiety or depressive disorder. Patients were presented 20 choice tasks with two hypothetical treatment scenarios for relapse prevention, plus a "no treatment" option. Each treatment scenario was based on seven attributes of a hypothetical but realistic relapse prevention programme. Attributes considered professional contact frequency, treatment type, delivery mode, programme flexibility, a personal relapse prevention plan, time investment and effectiveness. Choice models were estimated to analyse the data.

Results: A total of 109 patients with a partially or fully remitted anxiety or depressive disorder completed the DCE. Attributes with the strongest impact on choice were high effectiveness, regular contact with a professional, low time investment and the inclusion of a personal prevention plan. A high heterogeneity in preferences was observed, related to both clinical and demographic characteristics: for example, a higher number of previous treatment episodes was related to a preference for a higher frequency of contact with a professional, while younger age was related to a stronger preference for high effectiveness.

Conclusions: This study using a DCE provides insights into preferences for a relapse prevention programme for anxiety and depressive disorders that can be used to guide the development of such a programme.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / psychology*
  • Choice Behavior*
  • Depression / psychology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Preference
  • Probability
  • Recurrence
  • Secondary Prevention*
  • Self Report
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

Funding was received from the Netherlands Organisation for Health Research and Development (ZonMw) (projectnr. 430000003). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.