患者偏好对焦虑症和抑郁症治疗的临床效果、满意度和依从性的影响:元分析

IF 3.2 3区 心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-05-05 DOI:10.1002/cpp.2985
Eline Eigenhuis, Vanessa E. M. van Buuren, Rosa E. Boeschoten, Anna D. T. Muntingh, Neeltje M. Batelaan, Patricia van Oppen
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引用次数: 0

摘要

背景 在过去的几十年中,考虑患者的偏好已受到越来越多的关注。我们进行了一项荟萃分析,以估计患者偏好对抑郁症和焦虑症治疗的临床结果、满意度和依从性的影响。 方法 在 Pubmed、Embase、PsycINFO 和 Scopus 上检索(群组)随机对照试验。共纳入 26 项随机对照临床试验,共有 3670 人参与,研究了患者对焦虑症和抑郁症治疗的偏好对临床结果、满意度和/或依从性的影响。 结果 未发现患者偏好对临床结果有影响[d = 0.06,95% CI = (-0.03,0.15),p = 0.16,n = 23 项研究]。发现患者偏好对治疗满意度[d = 0.33,95% CI = (0.08,0.59),p = 0.01,n = 6项研究]和治疗依从性[OR = 1.55,95% CI = (1.28,1.87),p < 0.001,n = 22项研究]有微小影响。 局限性 患者偏好是一个不同的概念,今后的研究应努力实现偏好操作的均等化。本研究中的亚组分析应谨慎解释,因为每个分析亚组的研究数量普遍较少。本荟萃分析所包含的大多数研究都侧重于抑郁症患者。关于满意度的研究较少(6 项),因此我们无法得出确切的结论。 结论 虽然本荟萃分析未发现考虑患者偏好对临床结果有积极影响,但这与治疗满意度和依从性略有提高有关。考虑焦虑症和抑郁症患者的偏好可以改善治疗效果。 试验注册 PROSPERO: CRD42020172556
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The Effects of Patient Preference on Clinical Outcome, Satisfaction and Adherence Within the Treatment of Anxiety and Depression: A Meta-Analysis

Background

Taking patient preference into consideration has received increased attention in the last decades. We conducted a meta-analysis to estimate the effects of patient preference on clinical outcome, satisfaction and adherence regarding treatment of depression and anxiety.

Methods

Pubmed, Embase, PsycINFO and Scopus were searched for (cluster) randomized controlled trials. Twenty-six randomized controlled clinical trials were included, comprising 3670 participants, examining the effect of patient preference regarding treatment of anxiety and depression on clinical outcome, satisfaction and/or adherence.

Results

No effect of patient preference was found on clinical outcome [d = 0.06, 95% CI = (−0.03, 0.15), p = 0.16, n = 23 studies]. A small effect of patient preference was found on treatment satisfaction [d = 0.33, 95% CI = (0.08, 0.59), p = 0.01, n = 6 studies] and on treatment adherence [OR = 1.55, 95% CI = (1.28, 1.87), p < 0.001, n = 22 studies].

Limitations

Patient preference is a heterogeneous concept, future studies should strive to equalize operationalization of preference. Subgroup analyses within this study should be interpreted with caution because the amount of studies per analysed subgroup was generally low. Most studies included in this meta-analysis focused on patients with depression. The small number of studies (n = 6) on satisfaction, prevents us from drawing firm conclusions.

Conclusions

While this meta-analysis did not find a positive effect of considering patient preference on clinical outcome, it was associated with slightly better treatment satisfaction and adherence. Accommodating preference of patients with anxiety and depression can improve treatment.

Trial Registration

PROSPERO: CRD42020172556

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来源期刊
Clinical psychology & psychotherapy
Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-
CiteScore
6.30
自引率
5.60%
发文量
106
期刊介绍: Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.
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