Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 10;13(7):e0200490.
doi: 10.1371/journal.pone.0200490. eCollection 2018.

Development and pilot of a decision-aid for patients with bipolar II disorder and their families making decisions about treatment options to prevent relapse

Alana Fisher  1   2 , Louise Sharpe  1 , Josephine Anderson  3   4 , Vijaya Manicavasagar  3   4 , Ilona Juraskova  1   2
Affiliations

Development and pilot of a decision-aid for patients with bipolar II disorder and their families making decisions about treatment options to prevent relapse

Alana Fisher et al. PLoS One. .

Abstract

Introduction: Treatment decisions in bipolar II disorder (BPII) are finely-balanced and sensitive to patient preferences. This pilot study evaluated a decision-aid booklet (DA) for patients with BPII (and their family) to obtain evidence on its acceptability, feasibility, safety, and usefulness in potential end-users.

Methods: The DA booklet was developed according to International Patient Decision-Aid Standards. Thirty-one patients diagnosed with BPII and their families (n = 11), who were currently making or had previously made treatment decisions, participated. Participants read the DA and completed validated and purpose-designed questionnaires. A follow-up semi-structured telephone interview elicited more in-depth DA feedback (n = 40).

Results: Patients and family endorsed the DA booklet as: easy-to-use (100% agree), useful in treatment decision-making (100%), presenting balanced (patients = 96.8%, family = 100%), up-to-date (93.5%, 100%) and trustworthy information (93.5%, 100%) that did not provoke anxiety (93.5%, 90.9%). All participants stated that they would recommend the DA to others. Following DA use, all except one participant (97.6%) demonstrated adequate treatment knowledge (> 50% score). Patients reported low decisional conflict (M = 18.90/100) following DA use and felt well-prepared to make treatment decisions (M = 4.28/5). Most patients (90.3%) indicated uptake of treatments consistent with the best available clinical evidence. Additionally, a large proportion of patients made an informed choice about medication (65.5%) with adjunctive psychological treatment (50.0%), based on adequate knowledge and their treatment values. Interview findings further supported the DA's acceptability among participants.

Discussion: Pilot findings indicate that patients with BPII and their family consider this DA booklet highly acceptable and useful in making evidence-based treatment decisions that align with their treatment preferences.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disorders. 2013;15(1):1–44. doi: 10.1111/bdi.12025 - DOI - PubMed
    1. Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Möller H-J, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. The World Journal of Biological Psychiatry. 2013;14(3):154–219. doi: 10.3109/15622975.2013.770551 - DOI - PubMed
    1. Fountoulakis KN. Treatment guidelines In: Fountoulakis KN, editor. Bipolar Disorder: An Evidence-Based Guide to Manic Depression. Verlag Berlin Heidelberg: Springer; 2015. p. 643–58.
    1. Fountoulakis KN. Psychosocial treatment and interventions In: Fountoulakis KN, editor. Bipolar Disorder: An Evidence-Based Guide to Manic Depression. Verlag Berlin Heidelberg: Springer; 2015. p. 627–42.
    1. Malhi G, Adams D, Lampe L, Paton M, O’Connor N, Newton L, et al. Clinical practice recommendations for bipolar disorder. Acta Psychiatrica Scandinavica. 2009;119(s439):27–46. - PubMed

Publication types