Patient Preferences in Mental Health Disorders: A Qualitative Study Investigating Unmet Medical Needs and Therapy Preferences of Patients With Non-Affective Psychotic Disorder

OBJECTIVES: Non-affective psychotic disorders (NAPD) including schizophrenia are conditions that greatly affect patients’ quality of life and their social environment. Due to limitations regarding adequate treatments and optimal care management strategies, patients are left with various health(care) and societal needs. This research aims to identify patients’ unmet medical needs (UMN) and elicit their disease/treatment preferences to steer needs-driven research and enhance patient-centered care.

METHODS: A literature study with a systematic search was performed in PubMed using the following concepts and its synonyms: “Unmet Medical Needs”, “Patient Preferences” and “Schizophrenia”. Qualitative semi-structured interviews are planned with Belgian patients living with NAPD (n=25) to explore the most important disease or treatment attributes.

RESULTS: The literature search retrieved 3513 articles. After de-duplication (n= 51), 3462 articles were screened on title/abstract. Only 311 eligible articles were subsequently screened on full text, resulting in a total of 173 included articles. Results showed that UMN in NAPD are mostly related to physical and mental health needs (e.g., chronic health conditions, lack of coping strategies), treatment-related needs such as inefficacy to address all symptoms, treatment side effects (e.g., weight gain, akathisia)), social needs including difficulties with social activities (e.g., loneliness, social anxiety), lack of employment and stigmatization. Literature on patient preferences highlighted that burden of treatment side effects, mode and frequency of medication administration, and managing positive symptoms (e.g. delusions) were the most frequently reported attributes. Data collection for the qualitative interviews is ongoing and full results of the literature review and the interviews will be presented.

CONCLUSIONS: Patients with NAPD experience UMN related to their disease, treatment and social activities yet previous patient preference research primarily focuses on treatment-related characteristics. It is imperative to extend patient preference research to other domains (e.g., social disease characteristics) to evaluate their importance and align care management strategies with patients’ needs, preferences and priorities.