Factors influencing patient preferences for pharmacological and non-pharmacological treatment options in chronic health conditions: a systematic review.

BACKGROUND: Understanding patient preferences is vital for promoting person-centred care, treatment adherence, and better health outcomes. Preferences across pharmacological and non-pharmacological therapies may be influenced by a range of personal and contextual factors, but they are seldom explicitly described and considered in treatment recommendations. AIMS: To review the factors influencing patient preferences for various treatment options across a range of chronic health conditions. METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Literature was searched across Google Scholar, PubMed, EMBASE, CINAHL, and Medline (inception to April 2025), including English-language studies examining patient preferences for pharmacological and non-pharmacological treatment options in chronic health conditions. Studies were screened against predefined criteria and synthesized narratively. RESULTS: Seventeen studies were identified, involving persons diagnosed with osteoporosis, stroke, depression, early cancer, acute myeloid leukemia or advanced myelodysplastic syndrome, multiple chronic diseases, and people in aged care. Factors influencing preferences included sex/gender, age, beliefs (e.g. health conditions, treatment), ethnicity and culture, economic concerns, prior treatment experiences, perceptions of treatment safety and effectiveness, accessibility, interaction with healthcare providers, and family and social support. Among these, age was the most common influencer, with older adults more likely to prefer non-pharmacological strategies. Sex/gender also shaped preferences; females/women were more inclined toward non-pharmacological strategies. Ethnocultural beliefs were linked to increased use of complementary and alternative medicines. Furthermore, patients tended to prefer treatments they perceived as having fewer side-effects and greater long-term efficacy. Alignment with patients' preferred treatments was associated with greater satisfaction and improved clinical outcomes. CONCLUSION: This review underscores the multifactorial nature of patient preferences, shaped by demographics, culture, and perceptions. These findings highlight the importance of considering patient preferences in clinical trials and when developing treatment guidelines.