Discrete Choice Experiments to Elicit Patient Preferences for the Treatment of Major Depressive Disorder: A Systematic Review.

BACKGROUND: Individual preferences for treatment options for major depressive disorder can impact therapeutic decision making, adherence, and ultimately outcomes. OBJECTIVES: This systematic review of discrete choice experiments (DCEs) on patient preferences for major depressive disorder treatment assessed the range of DCE applications in major depressive disorder to document patient stakeholder involvement in DCE development and to identify the relative importance of treatment attributes. METHODS: We searched MEDLINE via Ovid (1946-present), EMBASE (Elsevier interface), Cochrane Central Register of Controlled Trials (Wiley interface), and PsycINFO (EBSCO interface) databases on 29 May, 2024. Covidence software facilitated the review, which four members completed independently. The review was conducted in two phases: title and abstract and then a full-text review. We used an established quality reporting tool to evaluate selected articles. The Covidence extraction tool was adapted for this study. RESULTS: A total of 19 articles were included in this review. Most studies elicited preferences for depression treatment (63.2%) and care delivery (10.5%). Two assessed willingness to pay. Individuals prefer a combination of medicine and counseling over each treatment alone. Treatment efficacy, relapse prevention, and symptom relief were among the most important attributes. Individuals were willing to accept larger risks to achieve symptom improvement. Few studies examined preference heterogeneity with latent subgroups. CONCLUSIONS: Discrete choice experiments for major depressive disorder treatment preferences enable an assessment of trade-offs for first-line therapeutic options. Patient stakeholders are infrequently involved as collaborators in the DCE development. Few examined preference heterogeneity among subgroups.

Emergent Social Capital during the Coronavirus Pandemic in the United States in Hispanics/Latinos.

The coronavirus pandemic has drastically impacted many groups that have been socially and economically marginalized such as Hispanics/Latinos in the United States (U.S.). Our aim was to understand how bonding social capital, bridging social capital, and trust played a role in Hispanics/Latinos over the course of the COVID-19 outbreak, as well as explore the negative consequences of social capital. We performed focus group discussions via Zoom (n = 25) between January and December 2021 with Hispanics/Latinos from Baltimore, MD, Washington, DC, and New York City, NY. Our findings suggest that Hispanics/Latinos experienced bridging and bonding social capital. Of particular interest was how social capital permeated the Hispanic/Latino community's socioeconomic challenges during the pandemic. The focus groups revealed the importance of trust and its role in vaccine hesitancy. Additionally, the focus groups discussed the dark side of social capital including caregiving burden and spread of misinformation. We also identified the emergent theme of racism. Future public health interventions should invest in social capital, especially for groups that have been historically marginalized or made vulnerable, and consider the promotion of bonding and bridging social capital and trust. When prospective disasters occur, public health interventions should support vulnerable populations that are overwhelmed with caregiving burden and are susceptible to misinformation.