National Survey of Decision-Making for Antidepressants and Educational Level

Brodney, Suzanne; Fowler, Floyd J.; Stringfellow, Vickie L.; Valentine, K. D.; Barry, Michael J.

doi:10.3122/jabfm.2020.01.190120

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…Effective shared decision making requires asking patients what they prefer. The SDM Process scores were fairly low compared to other conditions [ 12 , 20 ], but were similar to previously published SDM Process scores for depression treatment [ 13 ]. The patient responses on the individual items in the SDM Process scale revealed that 265 (80.8%) discussed options, 66 (20.1%) discussed pros (a lot or some), 28 (8.5%) discussed cons (a lot or some), and 228 (69.5%) were asked their preference; this is similar to how treatment decisions are discussed and framed [ 12 ].…”

Section: Discussionsupporting

confidence: 85%

“…Also, patients who reported receiving the DA may have different knowledge than those who received and reviewed the DA. Whether or not patients received a DA, there is still a significant knowledge deficit for patients in the sample, which is similar to a national study that found patients had inadequate knowledge about depression treatment [ 13 ].…”

Section: Discussionsupporting

confidence: 60%

“…Data from past national surveys indicates that people with depression are not informed about depression or its treatments [ 10 – 12 ]. Patients with depression who had less formal education were less informed, less involved in the decision making process and less likely to report they would make the same decision again [ 13 ]. When treatment decisions between patients and clinicians are not shared, patients are more likely to receive treatment that does not match their values [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms

Brodney

Valentine

Sepucha

2021

BMC Med Inform Decis Mak

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Background A high quality treatment decision means patients are informed and receive treatment that matches their goals. This research examined the reliability and validity of the Depression Decision Quality Instrument (DQI), a survey to measure the extent to which patients are informed and received preferred treatment for depression. Methods Participants were aged 18 and older from 17 US cities who discussed medication or counseling with a physician in the past year, and physicians who treated patients with depression who practiced in the same cities. Participants were mailed a survey that included the Depression-DQI, a tool with 10 knowledge and 7 goal and concern items. Patients were randomly assigned to either receive a patient decision aid (DA) on treatment of depression or no DA. A matching score was created by comparing the patient’s preferred treatment to their self-reported treatment received. Concordant scores were considered matched, discordant were not. We examined the reliability and known group validity of the Depression-DQI. Results Most patients 405/504 (80%) responded, 79% (320/405) returned the retest survey, and 60% (114/187) of physicians returned the survey. Patients’ knowledge scores on the 10-item scale ranged from 14.6 to 100% with no evidence of floor or ceiling effects. Retest reliability for knowledge was moderate and for goals and concerns ranged from moderate to good. Mean knowledge scores differentiated between patients and physicians (M = 63 [SD = 15] vs. M = 81 [SD = 11], p < 0.001), and between patients who did and didn’t receive a DA (M = 64 [SD = 16] vs. M = 61 [SD = 14], p = 0.041). 60.5% of participants received treatment that matched their preference. Based on the multivariate logistic regression, ‘avoiding taking anti-depressants’ was the only goal that was predictive of taking mediation (OR = 0.73 [0.66, 0.80], p < 0.01). Shared Decision Making Process scores were similar for those who matched their preference and those who didn’t (M = 2.18 [SD = 0.97] vs. M = 2.06 [SD = 1.07]; t(320) = − 1.06, p = 0.29). Those who matched had lower regret scores (matched M = 1.72 [SD = 0.74] vs. unmatched M = 2.32 [SD = 0.8]; t(301) = − 6.6, p < .001). Conclusions The Depression DQI demonstrated modest reliability and validity. More work is needed to establish validity of the method to determine concordance. Trial registration: NCT01152307.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

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Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms

Brodney

Valentine

Sepucha

2021

BMC Med Inform Decis Mak

Self Cite

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“…4 Our results show that the education level of patients may influence their self-efficacy and preparedness for decisionmaking. Although a lower education level has been reported to be associated with lower scores of involvements in shared decision-making, 20 education level alone cannot reflect the patient's capacity to obtain, process, and understand basic health information and services, ie, health literacy. Routinely screening patients for health literacy has not been shown to improve outcomes and is not recommended.…”

Section: Discussionmentioning

confidence: 99%

Development and Pilot Usefulness Testing of an Interactive Computerized Patient Decision Aid for Intraocular Lens Selection Before Cataract Surgery

Tsai¹,

Fang²,

Chen³

et al. 2022

PPA

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Purpose Modern cataract surgeries aim to treat impaired vision and also improve quality of life. An appropriate pre-operative selection of the intraocular lens is important to post-operative quality of life. Patients often have difficulty in choosing the best fit for individual needs. Patient decision aids (PDAs) are useful tools to assist patients in such decision-making process. However, most PDAs are paper-based and lack user interaction. This study is aimed to develop and evaluate an interactive computerized patient decision aid (cPDA) to help patients in the selection of an appropriate intraocular lens model before cataract surgery. Materials and Methods Patients and their families who were making the decision regarding intraocular lens selection before cataract surgeries were eligible to participate in this study. A cPDA was built on an interactive robot, to help the patients in the decision-making process. The usefulness of the cPDA was measured with the Decision Self-Efficacy (DSE) scale and Preparation for Decision Making (PrepDM) scale. Results A total of 50 participants (18 men and 32 women) were enrolled in the pilot test. The mean pre-cPDA DSE score was 46.5 ± 13.6, and the post-cPDA DSE score was 72.6 ±12.8. The average gain score on DSE was 26.1, and the standard deviation was 8.0. The gain score on DSE was statistically significant, and the effect size was bigger than 3. The patients with junior or senior high degrees had the highest gain score on DSE, and the ones with college or above degrees had the lowest. The patients with college or above degrees had the highest PrepDM score, and the ones with elementary school or below had the lowest. Age and sex were not significant correlates of PrepDM. The patients with college or above degrees had the highest preparedness, but the lowest gain on DSE. Conclusion Education levels are associated with the usefulness of cPDA, both for the preparedness and decision efficacy of patients. The results provide insight into the feasibility of cPDA for the decision-making of pre-operative intraocular lens selection.

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“…The team lead by Purkable 13 conducted an intervention to promote discussions of quality of life goals. The associations between education level, depression care, and shared decision making is explored in the article by Brodney et al 14…”

Section: Family Medicine Carementioning

confidence: 99%

Family Medicine and the “New” Opioid Epidemic

Johnson¹

2020

J Am Board Fam Med

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National Survey of Decision-Making for Antidepressants and Educational Level

Cited by 7 publications

References 41 publications

Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms

Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms

Development and Pilot Usefulness Testing of an Interactive Computerized Patient Decision Aid for Intraocular Lens Selection Before Cataract Surgery

Family Medicine and the “New” Opioid Epidemic

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