Background: Treatment choices for depression are preference-sensitive (no "single best option"). However, factors or attributes that can enhance or inhibit patient choice have not been fully explored.
Aims: To synthesize the qualitative literature on facilitators and barriers to treatment choice, from the perspective of people with depression and healthcare practitioners.
Methods: A systematic literature search identified eligible qualitative studies (Protocol registration no. CRD42019151352). Findings from 56 studies were meta-synthesized using a thematic analysis approach.
Results: Overarching facilitators to treatment choice that resonated with both patients and healthcare practitioners included: a trusting and respectful patient-practitioner relationship; information and guidance tailored to the individual and their preferred level of involvement in the decision-making process; eliciting and incorporating patient preferences and individual needs in order to find the best patient-treatment match. Prominent barriers to treatment choice that emerged were: limited time available to explore treatment options; inadequate mental health training, knowledge, skills, and experience; lack of psychological treatment services and waiting times; inflexibility of services.
Conclusions: By focusing on the factors identified, practitioners can facilitate patient participation in decision-making, which has the potential to improve engagement with treatment and outcomes for adults with depression.
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