Predictors of Treatments Acceptable to Patients for Late-Life Depression

OBJECTIVES Describe older patients' perceptions about depression and characteristics associated with acceptance of treatments. DESIGN Cross-sectional study. SETTING Three primary care clinics in Iowa. PARTICIPANTS Consecutive sample of 529 primary care patients. MEASUREMENTS Depression screening tool (a 9-item patient health questionnaire [PHQ-9]) and questionnaire including sociodemographic data, patient attitudes about depression, and acceptability of different treatments. RESULTS Mean age was 71.9 years (range 60-93 years), 314 (59%) female. Among the 529 participants, 93 (17.5%) had history of depression and 60 (11.3%) had PHQ-9 scores of 10 or greater. Participants believed depression is a disease for which they would use medication and counseling. Accepting medications from primary physicians was strongly associated with a past history of depression (P < 0.01) and with agreeing that depression needs treatment (P < 0.01). Counseling was not acceptable for those believing that they can control depression on their own (P < 0.01). Older patients (P < 0.001) and those with higher education levels (P < 0.01) were less likely to accept herbs or supplements as treatment options. Willingness to discuss treatments with family was associated with not using alcohol as a treatment and acceptance of all other treatment options (P < 0.001). CONCLUSIONS Attitude that depression is a disease and the willingness to discuss depression with family may enhance treatment acceptance.