Design and Implementation of Antidepressant Decision Making Aids

Abstract

Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient’s medication adherence needs to be addressed in future studies.