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Decision aid improves primary care of patients with depression
A newly developed decision aid helped clinicians and patients with depression choose antidepressants, according to study findings published in JAMA Internal Medicine.
The Depression Medication Choice (DMC) decision aid, developed by Annie LeBlanc, PhD, a researcher at the Mayo Clinic, and colleagues, did not affect depression outcomes or medication adherence.
"Decision aids are evidence-based interventions designed to engage patients and clinicians in [a shared decision making (SDM)] process and translate research evidence into patient-centered care," LeBlanc and colleagues wrote. "A body of evidence (115 randomized trials) demonstrates that decision aids increase patients' knowledge and engagement in and comfort with the decision-making process."
Annie LeBlanc
Researchers conducted a cluster randomized trial of 117 clinicians and 301 patients with moderate-to-severe depression to assess differences in decision making and depression outcomes when using the DMC. They analyzed participant surveys, including the Decisional Conflict Scale and the Patient Health Questionnaire for depression.
Results showed that, compared with control patients, using the DMC significantly improved patient decisional comfort (mean difference, 5.3 out of 100; 95% CI, 1.1-9.5; P = .01) and knowledge (OR, 9.5; 85% CI, 0.8-18.2; P = .03). Clinicians were more comfortable (MD, 11.4 out of 100; 95% CI, 17.1-5.7; P <.001) and satisfied (RR = 1.64; P = .02) when the DMC was utilized. Results also demonstrated no differences between the groups in terms of medication adherence or improvement of depression control.
"Depression Medication Choice is a novel and efficient SDM tool," LeBlanc and colleagues concluded. "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. Depression Medication Choice can help patients and their clinicians identify and implement treatment that best fits the patient's values, preferences, and goals in a timely way — a path to higher-quality health care." – by Chelsea Frajerman Pardes
Disclosures: The authors report no relevant financial disclosures.