Effectiveness of a decision aid for patients with depression: A randomized controlled trial

Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Juan Antonio Sanchez-Afonso, Jeanette Perez-Ramos, Carmen Luisa Castellano-Fuentes, Karen Sepucha, Pedro Serrano-Aguilar, Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Juan Antonio Sanchez-Afonso, Jeanette Perez-Ramos, Carmen Luisa Castellano-Fuentes, Karen Sepucha, Pedro Serrano-Aguilar

Abstract

Background: Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices.

Objective: The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression.

Design: Randomized controlled trial.

Setting and participants: Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79).

Intervention: Patients in the decision aid group reviewed the decision aid accompanied by a researcher.

Outcome measures: Knowledge about treatment options, decisional conflict, treatment intention and preference for participation in decision making. We also developed a pilot measure of concordance between patients' goals and concerns about treatment options and their treatment intention.

Results: Intervention significantly improved knowledge (P<.001) and decisional conflict (P<.001), and no differences were observed in treatment intention, preferences for participation, or concordance. One of the scales developed to measure goals and concerns showed validity issues.

Conclusion: The decision aid "Decision making in depression" is effective improving knowledge of treatment options and reducing decisional conflict of patients with unipolar depression. More research is needed to establish a valid and reliable measure of concordance between patients' goals and concerns regarding pharmacological and psychological treatment, and the choice made.

Keywords: Spain; decision aid; depression; patient involvement (empowerment, self-management); primary care; randomized controlled trial; shared decision making.

© 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
CONSORT flow diagram of participants through the study

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