Examining the Impact of Patient-Reported Hope for Improvement and Patient Satisfaction with Clinician/Treatment on the Outcome of Major Depressive Disorder Treatment
Waguih William IsHak *
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
Jennice Vilhauer
Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA
Richard Kwock
School of Public Health, University of California Los Angeles, Los Angeles, California, USA
Fan Wu
School of Public Health, University of California Los Angeles, Los Angeles, California, USA
Sherif Gohar
University of California Davis Law School, Davis, California, USA
Katherine Collison
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA
Shannon Nicole Thomas
Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center Los Angeles, California 90048, USA
Lancer Naghdechi
Western University of Health Sciences, College of Osteopathic Medicine, Pomona, California, USA
David Elashoff
School of Public Health, University of California Los Angeles, Los Angeles, California, USA
*Author to whom correspondence should be addressed.
Abstract
Aims: This analysis aims at examining if patient-reported variables such as hope for improvement and patient satisfaction with clinician/treatment could influence the outcome major depressive disorder (MDD) treatment, namely depression remission, in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.
Study Design: Retrospective cohort study.
Place and Duration of Study: The STAR*D study was conducted at 18 primary care and 23 psychiatric care settings in the United States from 2001-2007 and was funded by the National Institute of Mental health (NIMH). The analysis contained in this manuscript was conceptualized at the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and performed at the UCLA School of Public Health.
Methodology: Using data from STAR*D, the current study used logistic regression and survival analyses to examine the relationship between depressive symptoms remission and two sets of self-reported factors: Hope for improvement and, Patient satisfaction with treatment/clinician.
Results: First, more than 90% of STAR*D patients reported having high hope for improvement (agree or strongly agree) and more than 66% endorsed high satisfaction with clinicians and more than 50% expressed high satisfaction with treatments (very or mostly satisfied). Second, hope for improvement was predictive of depression remission (p<0.05). Third, satisfaction with clinician/treatment, did not predict remission.
Conclusion: This study shows the impact that patients’ subjective hope for improvement can have on predicting depression remission in contrast to satisfaction with clinician/treatment. Future studies should prospectively incorporate patients’ subjective attitudes regarding hope for improvement and satisfaction with clinicians and treatments as mediators and moderators of MDD treatment success.
Keywords: Major depressive disorder, hope, patient satisfaction, remission