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. 2025 Mar 19;25(1):255.
doi: 10.1186/s12888-025-06606-9.

A survey of patient-physician communication regarding treatment prospects and goal setting in the management of major depressive disorder in Japan

Takashi Tsuboi  1 , Takeo Nakayama  2 , Junko Horie  3 , Fumie Tokuda  3 , Yoshiya Moriguchi  4 , Tatsuya Hoshino  5
Affiliations

A survey of patient-physician communication regarding treatment prospects and goal setting in the management of major depressive disorder in Japan

Takashi Tsuboi et al. BMC Psychiatry. .

Abstract

Background: Major depressive disorder (MDD) is a common and debilitating cause of disability worldwide. Recently, it has been suggested that individualized goal setting may play a role in patient-centered recovery. This study aimed to survey the landscape of patient-physician communication around goal setting for MDD treatment, as well as understand whether goal setting using the SMART (specific, measurable, attainable, realistic, and time-bound) framework is associated with positive treatment indicators in MDD.

Methods: Patients in Japan (≥ 18 years of age) who self-reported a verified MDD diagnosis were eligible to complete a self-administered survey through the Personal Health Record service, a web-based smartphone app. Patients were asked about whether they communicated with physicians about treatment prospects and/or goals. A 'SMART-Goal score' tool was developed to evaluate patient goals against the five SMART criteria. Treatment satisfaction scores and scores on the Wake Forest Physician Trust Scale Short Version (TRUST) were assessed as indicators of outcomes in this study. Descriptive questions were used to explore patients' perceptions of goal setting.

Results: In total, 466 patients were eligible for inclusion in the analysis. The majority (70.0%) reported communicating with their physicians about treatment prospects and/or goals. These patients (Com + group) had a median (Q1, Q3) TRUST score of 70.0 (60.0, 80.0), compared with 50.0 (40.0, 70.0) in patients who reported an absence of communication (Com - group). Median (Q1, Q3) treatment satisfaction scores were 5.0 (4.0, 6.0) and 4.0 (3.0, 5.0) for the Com + and Com - groups, respectively. In high SMART-Goal scoring groups, approximately 75% of patients exceeded the overall median scores for TRUST (70.0) or treatment satisfaction (5.0) reported for the Com + group; only 25% of patients in low SMART-Goal scoring groups achieved the same in either measure. Most patients (89.3%) who set goals recommended goal setting.

Conclusions: This exploratory study suggests that communication between patients and physicians regarding goal setting in MDD treatment may be associated with positive patient perceptions of treatment. High-quality SMART goal setting also appears to have positive aspects for patients with MDD, which may in turn affect treatment outcomes. Further studies are needed to confirm these initial findings.

Trial registration: Registered on the UMIN Clinical Trials Registry (ID: UMIN000050370) on 17 February 2023.

Keywords: Goals; Japan; Major depressive disorder; Patient-centered care; SMART.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This survey was approved by the Kyoyukai RiverSide Clinic Institutional Review Board (Sapporo, Japan) before initiation (protocol approval number: RSC-2301RB01) and was conducted in compliance with Ethical Guidelines for Medical and Health Research Involving Human Subjects [41]. Informed participant consent was obtained both at the time of registration for Pep Up, and at the time of survey administration. Analyses were carried out by JMDC, Inc., and stored for 5 years. Analysis of survey respondent data was performed on information provided after processing for anonymity, and therefore did not contain personal information or require personal consent. Competing interests: T.T. has received consultant fees or speaker honoraria from Eli Lilly, Meiji Seika Pharma, MSD, Janssen Pharmaceutical, Sumitomo Pharma, Mitsubishi Tanabe Pharma, Yoshitomi Yakuhin, Mochida Pharmaceutical, Otsuka, Kyowa Kirin, Tsumura, Viatris, Lundbeck Japan K.K., and Takeda Pharmaceutical Company Limited. T.N. has received research grants from I&H Co., Ltd., Cocokarafine Group Co., Ltd., and Konica Minolta Inc., NTT Data Japan Co.; consulting fees from Lundbeck Japan K.K., Otsuka Pharmaceutical, and Takeda Pharmaceutical Company Limited; honoraria from Pfizer Japan Inc., MSD K.K., Chugai Pharmaceutical Co., Takeda Pharmaceutical, Janssen Pharmaceutical K.K., Boehringer Ingelheim, Eli Lilly Japan K.K., Maruho Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Allergan Japan K.K., Novo Nordisk Pharma Ltd., TOA EIYO Ltd., Dentsu Group Inc., ONO PHARMACEUTICAL CO., LTD., GSK plc, Alexion Pharmaceuticals, Inc., Amicus Therapeutics, AbbVie GK, Eisai Co., Ltd, and Canon Medical Systems Co.; stock options from BonBon Inc.; and donations from CancerSCAN and YUYAMA Co. J.H., F.T., and T.H. are employees of Takeda Pharmaceutical Company Limited. Y.M. is an employee of Lundbeck Japan K.K.

Figures

Fig. 1
Fig. 1
Participant flow. MDD Major depressive disorder
Fig. 2
Fig. 2
Relationship between SMART-Goal score and outcomes. aThe correlation coefficients apply only to data from patients in the Com + group. Each SMART-Goal score group was compared with either: A Wake Forest Physician Trust Scale Short Version (TRUST) score, or B Treatment satisfaction score. Com − patients who did not communicate with physicians regarding goals, Com + patients who communicated with physicians regarding goals, SMART specific, measurable, attainable, realistic, time-bound
See this image and copyright information in PMC

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