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. 2017 Aug;20(4):714-723.
doi: 10.1111/hex.12510. Epub 2016 Oct 17.

Right choice, right time: Evaluation of an online decision aid for youth depression

Magenta B Simmons  1   2 , Aurora Elmes  1   2 , Joanne E McKenzie  3 , Lyndal Trevena  4 , Sarah E Hetrick  1   2
Affiliations

Right choice, right time: Evaluation of an online decision aid for youth depression

Magenta B Simmons et al. Health Expect. 2017 Aug.

Abstract

Background: Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this.

Objectives: The main objective of this study was to evaluate an online decision aid for youth depression.

Design: An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements.

Setting and participants: Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services.

Intervention: Online decision aid with evidence communication, preference elicitation and decision support components.

Main outcome measures: The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up.

Results: After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses.

Discussion and conclusions: A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population.

Keywords: adolescents; depression; patient decision aids; shared decision making; young adults.

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Figures

Figure 1
Figure 1
Assessment time points and related assessments for client and clinician participants
Figure 2
Figure 2
Recruitment rates and reasons for attrition
See this image and copyright information in PMC

References

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