Table 2.
Factors associated with remission and HRQOL at 12 months in the PHQ-9 positive cohort, the multivariable linear mixed effects models
| Remission (patient N = 322, doctor N = 54) | SF-12v2 PCS (patient N = 305, doctor N = 54) | SF-12v2 MCS (patient N = 305, doctor N = 54) | |
|---|---|---|---|
| Odds ratio (95% CI) | Coefficient (95% CI) | Coefficient (95% C.I.) | |
| Fixed effects | |||
| Intercept | 2.84 (0.34, 23.50) | 56.24* (48.37, 64.12) | 54.91* (45.20, 64.62) |
| Level 1: effects on patient factors | |||
| Gender (Male) | |||
| Female | 0.77 (0.42, 1.41) | −0.83 (−3.10, 1.44) | 1.02 (−1.78, 3.82) |
| Age | 0.98 (0.95, 1.00) | −0.10 (−0.20, 0.00) | 0.02 (−0.10, 0.14) |
| Ethnicity (Chinese) | |||
| Non-Chinese | 1.22 (0.21, 7.01) | 4.29 (−4.15, 12.74) | −6.54 (−16.95, 3.87) |
| Marital status (Married) | |||
| All others | 0.80 (0.45, 1.42) | −1.84 (−3.96, 0.28) | −1.26 (−3.87, 1.35) |
| Household monthly income (>HK$30000) | |||
| ≤HK$30000 | 1.58 (0.83, 3.00) | −1.33 (−3.76, 1.10) | 0.92 (−2.08, 3.92) |
| Education level (Secondary or tertiary education) | |||
| No formal or primary education | 0.98 (0.46, 2.07) | −1.87 (−4.58, 0.83) | 0.98 (−2.36, 4.31) |
| Working status (Employed) | |||
| Unemployed | 0.26 (0.04, 1.62) | −3.44 (−8.79, 1.91) | −5.54 (−12.13, 1.06) |
| Retired | 3.40* (1.29, 9.00) | −2.54 (−6.15, 1.08) | 5.98* (1.52, 10.43) |
| House-maker | 0.79 (0.33, 1.85) | −1.01 (−4.11, 2.10) | −2.40 (−6.22, 1.43) |
| Student | 1.15 (0.29, 4.59) | 1.12 (−3.77, 6.01) | −1.19 (−7.21, 4.84) |
| Smoking (Non-smoker) | |||
| Smoker | 0.63 (0.29, 1.37) | 1.14 (−1.69, 3.96) | −2.73 (−6.22, 0.76) |
| Drinking (Non-drinker) | |||
| Drinker | 1.46 (0.65, 3.28) | −1.15 (−4.14, 1.84) | 1.51 (−2.18, 5.20) |
| Exercise (With exercise) | |||
| No exercise | 1.24 (0.71, 2.15) | −2.55* (−4.57, −0.53) | 2.35 (−0.14, 4.85) |
| Number of co-morbidity (0) | |||
| 1 | 0.52 (0.27, 1.02) | −2.85* (−5.45, −0.24) | −0.53 (−3.74, 2.69) |
| ≥2 | 0.31* (0.15, 0.64) | −3.44* (−6.15, −0.73) | −3.50* (−6.84, −0.16) |
| Family history of mental illness (No) | |||
| Yes | 0.88 (0.44, 1.78) | 0.98 (−1.62, 3.58) | 2.22 (−0.99, 5.42) |
| Seen a western doctor in past 4 weeks (No) | |||
| Once or twice | 1.01 (0.59, 1.73) | −1.94 (−3.98, 0.10) | −1.95 (−4.47, 0.57) |
| More than twice | 0.48 (0.20, 1.12) | −9.57* (−12.63, −6.51) | −4.88* (−8.65, −1.11) |
| Seen a TCM practitioner in past 4 weeks (No) | |||
| Yes | 0.48* (0.24, 0.96) | −3.39* (−5.96, −0.83) | −2.65 (−5.81, 0.51) |
| District of residence (Hong Kong) | |||
| Kowloon | 0.91 (0.31, 2.70) | −0.65 (−4.80, 3.51) | 0.23 (−4.90, 5.36) |
| New Territories | 0.53 (0.19, 1.48) | −1.02 (−5.08, 3.04) | −1.58 (−6.59, 3.43) |
| Diagnosis of depression by doctor at baseline (No) | |||
| Yes | 0.90 (0.47, 1.72) | 0.62 (−1.75, 2.99) | −0.61 (−3.53, 2.32) |
| Take psychotropic drugs in the past 1 year (No) | |||
| Yes | 0.70 (0.39, 1.24) | 0.77 (−1.38, 2.93) | −3.89* (−6.54, −1.23) |
| PHQ-9 score at baseline | 1.00 (0.93, 1.08) | −0.24 (−0.51, 0.03) | −0.30 (−0.63, 0.04) |
| Level 2: effects on doctor factors | |||
| Gender (Male) | |||
| Female | 0.71 (0.35, 1.43) | 0.30 (−2.33, 2.93) | −1.55 (−4.80, 1.69) |
| Age | 1.00 (0.97, 1.03) | 0.04 (−0.07, 0.16) | −0.01 (−0.15, 0.12) |
| District of practice (Hong Kong) | |||
| Kowloon | 0.96 (0.31, 2.94) | 0.65 (−3.65, 4.94) | −2.18 (−7.47, 3.12) |
| New Territories | 1.43 (0.47, 4.28) | −1.12 (−5.41, 3.17) | 1.20 (−4.08, 6.49) |
| Previous education and training (None) | |||
| Family Medicine training | 1.70 (0.74, 3.90) | 4.83* (1.67, 7.99) | 2.10 (−1.80, 6.00) |
| Diploma in Psychological Medicine | 0.98 (0.40, 2.40) | 1.96 (−1.40, 5.33) | −0.91 (−5.06, 3.24) |
| Both of the above | 1.97 (0.57, 6.75) | 4.68* (0.19, 9.16) | 3.17 (−2.36, 8.70) |
| System setting (Public) | |||
| Private | 2.33 (0.95, 5.71) | 4.29* (0.87, 7.72) | 3.00 (−1.23, 7.22) |
| Error variance | |||
| Intercept | Not applicable | 0.00 (0.00) | 0.00 (0.00) |
| Intercept (doctor), variance, standard error | 0.00 (0.00) | 64.54 (5.23) | 98.14 (7.95) |
| Goodness-of-fit | |||
| Akaike Information Criterion (AIC) | 448.13 | 2206.55 | 2334.41 |
| Bayesian Information Criterion (BIC) | 576.47 | 2336.76 | 2464.62 |
Estimated with linear mixed effects models. The reference category of each patient and doctor factor was bracketed. For remission model, doctor intraclass correlation coefficient (ICC) = 4.49%. For SF-12v2 PCS model, doctor ICC = 13.17%. For SF-12v2 MCS model, doctor ICC = 0.00%.
*Statistically significant, P value <0.05.