0477 Patient Preferences for Evaluating Treatment of Depression and Insomnia

Abstract Introduction Insomnia and depression are highly prevalent, often co-morbid and contribute to substantial impairment and increased health risks. Although effective pharmacotherapy and psychotherapy treatments exist for both conditions, in real world practice, a minority of patients receive care for both, leading to residual symptoms for untreated conditions. Patient preference for treatment modality or sequence may impact outcomes. Research shows that aligning preferences to treatment conditions improves engagement, the therapeutic alliance, and attendance, whereas mismatches increase attrition. We sought to gather information on patient preferences to guide future research on optimal treatment sequencing, modality and matching via for individuals with co-occurring insomnia and depression. Methods We recruited participants via social media to complete an online self-report assessment. N = 101 participants met our inclusion criteria for co-occurring depression and insomnia and completed a 10-item preference survey including: depression and insomnia treatment (medication, therapy, no preference) and the importance of choice in the type of treatment and which problem should be treated first (not/somewhat, very, or extremely important, for each). Participants ordered the importance of indicators of treatment working from most to least important and described their likelihood of participating in research virtually over zoom, other audiovisual options and having study medications mailed sent to their home. Results Participants preferred therapy for depression (51%), medication for insomnia (57%), and most said it was extremely important to choose the type (55% for both) and sequencing of treatment (44%). Participants described sleep quality, energy, and mood as the top three indicators that treatment was working. Most were willing to engage in virtual (88%) and research where study medications are mailed to their home (71%). The most reported concern about online therapy was data safety (4 participants) while delayed/lost/stolen medicine, or fear of tampering were the most reported concerns about mailed medications (4 participants each). Conclusion Overall, participants with insomnia and depression have distinct preferences for treatment type and sequencing. Most prefer psychotherapy for depression, medication for insomnia, and want to have a choice in which condition is treated first. Understanding patient preferences will be useful in implementing and maximizing treatment efforts for those with co-morbid insomnia and depression. Support (if any)