Tuesday, September 29, 2015

Decision Tool Helps Patients Feel More Satisfied With Antidepressant Selection

A tool to help patients with depression make informed decisions about appropriate antidepressants improves the antidepressant decision-making process without extending the length of primary care visits, according to a report in JAMA Internal Medicine.

The tool, developed by researchers at the Mayo Clinic in Rochester, Minn., is called Depression Medication Choice (DMC). DMC consists of a series of cards that present general information about antidepressant efficacy and highlight various features of antidepressants—for instance, effects on sleep, sexual issues, and weight gain. The cards are used by the patient with the clinician during the primary care visit.

Primary care practices in 10 rural, suburban, and urban areas (117 clinicians and 301 patients) across Minnesota and Wisconsin were randomly assigned to treat depression with or without use of the DMC decision aid from December 2011 to November 2013.

After the encounters with their clinicians, patients in the decision aid arm reported significantly higher comfort with the decision and were more knowledgeable and satisfied compared with patients in the control arm. It also improved clinicians’ decisional comfort and satisfaction, without extending the time of the office visit.

However, there was no observed difference between the two groups in control of depression symptoms (mean Patient Health Questionnaire for depression [PHQ-9] score), remission rate (PHQ-9 score less than 5), or responsiveness (greater than 50% PHQ-9 improvement) at three and six months, or in medication use or adherence.

“Depression Medication Choice is a novel and efficient shared-decision-making tool,” the authors stated. “It effectively helps patients with moderate to severe depression and their primary care clinicians engage in collaborative deliberation by using evidence about the comparative effectiveness of antidepressants.”

For related information, see the Psychiatric News article “Risk-Benefit Analyses in Medication Decision Making.

Human Rights Expert to Be Keynote Speaker at APA’s Meeting in NYC

Adeyinka M. Akinsulure-Smith, Ph.D., is a licensed psychologist from Sierra Leone who has participated in human rights investigations in Sierra Leone, worked with war victims from the African diaspora and survivors of torture, and served as an expert on gender crimes and posttraumatic stress disorder in a case before the International Criminal Court. She will discuss her work and experiences on Thursday, October 8, at IPS:The Mental Health Services Conference, which is being held at the Sheraton New York Times Square Hotel. Learn more about the meeting and register now.

(Top image: Stuart Jenner/Shutterstock)


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