Article Figures & Data
Tables
Questions Yes Responses (%) During the past 6 months of depression treatment, were you: 1. Asked for your ideas and preferences regarding your depression treatment? 37.0 2. Asked about your concerns and questions with regard to depression treatment? 57.6 3. Sure that your doctor considered your values and goals when recommending treatment? 75.2 4. Provided with a treatment plan you could do in your daily life? 60.6 5. Asked about any problems or side effects from your treatments? 42.4 6. Asked whether you preferred medications or counseling? 34.2 Composite (standard deviation) 50.7 (32.8) Characteristics No. % Patients Sex Female 851 72.9 Male 317 27.1 Age (years) 18–34 344 29.5 35–49 391 33.5 50–64 347 39.7 ≥65 86 7.4 Ethnicity/race Non-Hispanic white 1022 87.5 Hispanic, any race 43 3.7 Non-Hispanic, nonwhite 103 8.8 Treated for this depression 0–5 weeks 543 46.5 ≥6 weeks 607 52.0 Other depression treatment in past 6 months Individual counseling 299 25.6 Group therapy 45 3.8 Psychiatry 69 5.9 Other treatment 41 3.5 Any treatment 376 32.2 General health Excellent/very good 383 32.8 Good 437 37.4 Fair/poor 348 29.8 PHQ-9 score 7–9 367 31.4 10–14 446 38.2 15–19 244 20.9 ≥20 111 9.5 Education High school or less 355 30.4 Some college, trade school 468 40.1 College degree or more 345 29.5 Marital status Married 569 48.7 Unmarried couple 101 8.6 Divorced/separated/widowed 268 22.9 Never married 229 19.6 Employment Employed for wages 696 59.6 Self-employed 69 5.9 Unemployed 117 10.0 Homemaker 45 3.9 Student 47 4.0 Retired 82 7.0 Unable to work 112 9.6 Household income Below poverty threshold 205 17.5 Between threshold and 2× threshold 166 14.2 More than 2× threshold 749 64.1 Declined to answer 48 4.1 Insurance type Commercial 792 67.8 State programs* 270 23.1 Medicare 61 5.2 Other 34 2.9 Clinics Adult PCPs in clinic (n) 1–4 159 13.6 5–10 510 43.7 ≥11 497 42.6 NPs/PAs in clinic (n) 0 124 10.6 ≥1 1044 89.4 Clinic location Urban 714 61.1 Rural 454 38.9 Medical groups Care sites in group (n) 1–4 274 23.5 5–10 98 8.4 ≥11 796 68.2 Psychiatrists in group (n) 0 390 33.4 ≥1 778 66.6 Mental health therapists in group (n) 0 385 33.0 ≥1 783 67.0 ↵* Medical Assistance, Prepaid Medical Assistance, Minnesota Care, Minnesota Senior Health Options.
NP, nurse practitioner; PA, physician assistant; PCP, primary care physician; PHQ-9, 9-item Patient Health Questionnaire.
- Table 3. Bivariate Relationships Between Patient, Clinic, and Group Characteristics and Shared Decision Making
Characteristics No. Mean* SD P Value Patients Sex Female 848 51.2 33.0 .40 Male 314 49.4 32.2 Age (years) 18–34 343 58.3 31.0 .03 35–49 390 53.3 32.4 50–64 345 44.5 32.8 <.001 ≥65 84 32.7 31.1 <.0001 Ethnicity/race Non-Hispanic white 1016 50.4 33.2 Hispanic, any race 43 45.7 30.9 .36 Non-Hispanic, nonwhite 103 55.8 29.4 .11 Treated for this depression 0–5 weeks 540 56.6 29.7 <.001 ≥6 weeks 604 45.5 34.5 Any other depression treatment in past 6 months No 788 46.0 33.1 Yes 371 60.5 30.0 <.0001 General health Excellent/very good/good 815 53.9 32.1 Fair/poor 347 43.1 33.2 <.001 PHQ-9 score 7–9 364 51.6 32.0 .75 10–14 444 50.8 33.5 15–19 243 49.9 32.6 .71 ≥20 111 49.1 33.2 .62 Education High school or less 354 47.2 31.6 .02 Some college, trade school 466 51.5 32.7 .46 College degree or more 342 53.2 34.0 Marital status Coupled 666 51.6 32.5 Not coupled 495 49.4 33.2 .26 Employment Employed 761 52.9 32.4 Not employed 401 46.5 33.2 .001 Household income Below 2× poverty threshold 389 49.1 32.5 Above 2× poverty threshold 744 52.0 33.1 .15 Insurance type Commercial 787 52.2 33.1 State programs 270 52.1 31.8 .95 Medicare 60 29.4 27.8 <.0001 Other 34 42.6 30.2 .09 Clinics Adult PCPs in clinic (n) 1–4 159 49.5 32.3 5–10 506 51.6 32.4 ≥11 495 50.0 33.5 NPs/PAs in clinic (n) 0 122 50.3 31.3 ≥1 1038 50.7 33.0 Clinic location Urban 709 50.1 32.8 Nonurban 453 51.6 32.8 Medical groups Care sites in group (n) 1 to 4 273 54.1 32.2 5 to 10 98 44.4 30.5 ≥11 791 50.3 33.2 Psychiatrists in group (n) 0 389 50.3 31.6 ≥1 773 50.9 33.4 Mental health therapists in group (n) 0 384 51.4 31.6 ≥1 778 50.3 33.4 ↵* Mean percentage of 6 items answered yes.
NP, nurse practitioner; PA, physician assistant; PCP, primary care physician; PHQ-9, 9-item Patient Health Questionnaire; SD, standard deviation.
- Table 4. Multivariate Model-Predicted Differences in Shared Decision Making Among Selected Patient Subgroups Relative to a Reference Group
Characteristics Only Main Effects Main Effects Plus Interaction Difference P Value* Difference P Value* Sex Female Ref Ref Male −2.2 .29 N/A Age (years) 18–34 4.2 .08 4.1 .08 35–49 Ref Ref 50–64 −7.6 .001 −7.8 <.001 ≥65 −16.0 <.001 −15.9 <.001 Ethnicity/race Non-Hispanic white Ref Ref Hispanic, any race −5.0 .31 N/A Non-Hispanic, nonwhite 4.2 .21 N/A Treated for this depression 0–5 weeks Ref Ref ≥6 weeks −11.0 <.001 −11.2 <.001 Any other depression treatment in past 6 months No Ref Ref Yes 14.0 <.0001 14.0 <.001 General health Excellent/very good/good Ref Ref Fair/poor −7.5 <.001 N/A Household income Below 2× poverty threshold −4.2 .04 −3.9 .06 Above 2× threshold Ref Ref General health by sex Female Excellent/very good/good Ref Fair/poor −4.7 .05 Male Excellent/very good/good 0.8 .74 Fair/poor −10.0 <.03 ↵* P value compares predicted difference to reference category.