Informed and patient-centered decision-making in the primary care visits of African Americans with depression

Hines, Anika L; Roter, Debra; Dinoso, Bri K. Ghods; Carson, Kathryn A.; Daumit, Gail L.; Cooper, Lisa A.

doi:10.1016/j.pec.2017.07.027

Cited by 8 publications

(2 citation statements)

References 43 publications

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“…Results from a meta-analysis of patient preferences for psychiatric disorders reported that overwhelmingly patients prefer psychological treatment compared with pharmacologic treatment. 12 Hines and colleagues 13 compared audiotapes of postvisit surveys from patients and their clinicians. They found that only 9% of depression-related treatment decisions met the basic elements of informed decision making.…”

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confidence: 99%

National Survey of Decision-Making for Antidepressants and Educational Level

et al. 2020

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Background: Despite recommendations to screen adults for depression in primary care, little is known about how people across education levels decide to treat their depression and factors that influence their decision. Methods: We conducted a secondary analysis of a national, probability-based web survey in Englishspeaking adults aged 40 or older living in the United States who reported they discussed starting or continuing an antidepressant with their clinician in the past 2 years. Respondents answered questions about knowledge, decision-making process, and demographics. Education level was analyzed using 5 ordered categories. The Shared Decision Making (SDM) Process score was used to assess patient involvement. Descriptive statistics, 2 tests, analysis of variance, and regression models were used to describe the data and test associations. Results: Of the 5682 people invited, 3396 answered questions about health decisions (59.8% response rate) and 385 reported discussing antidepressants. The mean percentage of knowledge questions answered correctly increased as education level increased (P ‫؍‬ .008). The mean SDM Process score also increased with education (P ‫؍‬ .001). There was an association between education and who made the treatment decision, suggesting that for respondents with less education, the clinician was more likely to decide (P ‫؍‬ .001). Respondents with less education were less likely to report they would definitely make the same decision again (P ‫؍‬ .000). Conclusions: Those with less education were even less informed, had lower SDM Process scores and were less likely to think they made the right decision about antidepressants. There is a need to ensure patients are better informed about and involved in treatment for depression. (J Am Board Fam Med 2020;33:80-90.

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confidence: 99%

National Survey of Decision-Making for Antidepressants and Educational Level

et al. 2020

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“…Previous research in depressive primary care patients similarly found that greater PIC significantly increased the probability of depression resolution, 19 whereas depressed patients report more positive perceptions of clinical care during highly patient-centred visits. 20 M-PICS was positively correlated with most domains of cardiac anxiety indicated by the CAQ, with the weak positive correlation between heart-focused attention and PIC reaching statistical significance ( r = 0.39; P = 0.02). This may suggest that greater involvement in care makes patients with HCM more likely to demonstrate symptoms of cardiac anxiety or that anxious patients may be motivated to maintain greater involvement in care.…”

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confidence: 85%