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Randomized Controlled Trial
. 2017 Oct;20(5):1096-1105.
doi: 10.1111/hex.12553. Epub 2017 Mar 10.

Effectiveness of a decision aid for patients with depression: A randomized controlled trial

Lilisbeth Perestelo-Perez  1   2   3 , Amado Rivero-Santana  2   3   4 , Juan Antonio Sanchez-Afonso  4 , Jeanette Perez-Ramos  2   4 , Carmen Luisa Castellano-Fuentes  4 , Karen Sepucha  5 , Pedro Serrano-Aguilar  1   2   3
Affiliations
Randomized Controlled Trial

Effectiveness of a decision aid for patients with depression: A randomized controlled trial

Lilisbeth Perestelo-Perez et al. Health Expect. 2017 Oct.

Abstract

Background: Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices.

Objective: The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression.

Design: Randomized controlled trial.

Setting and participants: Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79).

Intervention: Patients in the decision aid group reviewed the decision aid accompanied by a researcher.

Outcome measures: Knowledge about treatment options, decisional conflict, treatment intention and preference for participation in decision making. We also developed a pilot measure of concordance between patients' goals and concerns about treatment options and their treatment intention.

Results: Intervention significantly improved knowledge (P<.001) and decisional conflict (P<.001), and no differences were observed in treatment intention, preferences for participation, or concordance. One of the scales developed to measure goals and concerns showed validity issues.

Conclusion: The decision aid "Decision making in depression" is effective improving knowledge of treatment options and reducing decisional conflict of patients with unipolar depression. More research is needed to establish a valid and reliable measure of concordance between patients' goals and concerns regarding pharmacological and psychological treatment, and the choice made.

Keywords: Spain; decision aid; depression; patient involvement (empowerment, self-management); primary care; randomized controlled trial; shared decision making.

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Figure 1
CONSORT flow diagram of participants through the study
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