Monday, July 2, 2012

Treatment decision making for young people diagnosed with major depressive disorders: The case for shared decision making

Shared decision making (SDM) is a model of medical or treatment decision making that involves collaboration between a clinician and client. One way of implementing SDM is with the use of decision aids (DA), which have demonstrated effectiveness for non-psychiatric conditions and emerging evidence for adults diagnosed with mental disorders.

A theoretical basis for SDM for young people has been made, yet work in this area is in its infancy.

The aim is to develop an online, evidence-based, preference sensitive DA to support young people facing a choice about treatment for moderate to severe depression.

The DA was based on systematic reviews and semi-structured qualitative interviews that were conducted with clients (n=10), caregivers (n=5) and clinicians (n=22) about their experiences and beliefs about treatment decision making for young people diagnosed with major depressive disorders.

Further consultations were held with medical, consumer and caregiver experts and pilot testing completed the development process.

Data from interviews demonstrated that client preference for involvement in treatment decision making for depression is not static and may vary with different clients and at different times for the same client. Caregiver involvement was seen as optional.

All participants voiced a preference for interactive, evidence-based information to support decision making. Based on this and consultations with expert groups, a DA was developed and pilot tested. Clients and clinicians found the DA to be acceptable and useful, and their feedback was used to refine the DA.

Treatment decision making in this area is a complex process that can be supported with the use of an evidence-based, preference-sensitive DA. The development of this DA contributes to the emerging field of youth SDM and can now be further tested for effectiveness. Approaches such as this DA hold the potential to improve client satisfaction, adherence and clinical outcomes.

Ms Magenta Simmons,  Research Fellow Headspace Centre of Excellence in Youth Mental Health will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

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