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

Publisher: Wiley Country of Publication: England NLM ID: 9815926 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1369-7625 (Electronic) Linking ISSN: 13696513 NLM ISO Abbreviation: Health Expect Subsets: MEDLINE

Original Publication: Oxford, UK : Wiley, c1998-

Choice Behavior* ; Decision Support Techniques*; Depression/*diagnosis; Adolescent ; Child ; Cohort Studies ; Depression/therapy ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/therapy ; Female ; Humans ; Male ; Patient Participation ; Primary Health Care ; Young Adult

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.
(© 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.)

BMC Psychiatry. 2013 Dec 12;13:335. (PMID: 24330307)
Aust Fam Physician. 2014 Mar;43(3):147-50. (PMID: 24600679)
Cochrane Database Syst Rev. 2014 Jan 28;(1):CD001431. (PMID: 24470076)
Arch Gen Psychiatry. 2006 Mar;63(3):332-9. (PMID: 16520440)
Paediatr Child Health. 2008 Jan;13(1):19-24. (PMID: 19119348)
Patient Educ Couns. 2007 Jul;67(1-2):50-6. (PMID: 17350214)
BMJ Open. 2016 Jan 08;6(1):e009585. (PMID: 26747036)
Lancet. 2011 Jun 18;377(9783):2093-102. (PMID: 21652063)
Med Decis Making. 1995 Jan-Mar;15(1):25-30. (PMID: 7898294)
Cochrane Database Syst Rev. 2012 Nov 14;11:CD008324. (PMID: 23152255)
Med J Aust. 2015 Jun 1;202(10):533-6. (PMID: 26021365)
Trials. 2014 Nov 04;15:425. (PMID: 25370185)
Am J Psychiatry. 2009 Sep;166(9):1002-10. (PMID: 19651711)
Early Interv Psychiatry. 2011 Nov;5(4):381-8. (PMID: 22032552)
J Am Board Fam Med. 2014 Mar-Apr;27(2):199-208. (PMID: 24610182)
Patient Educ Couns. 2007 Aug;67(3):324-32. (PMID: 17509808)
Patient Educ Couns. 2013 Oct;93(1):95-101. (PMID: 23669153)
BMJ. 2006 Aug 26;333(7565):417. (PMID: 16908462)
PLoS One. 2009;4(3):e4705. (PMID: 19259269)
BMC Psychiatry. 2011 Dec 12;11:194. (PMID: 22151735)
Lancet. 2012 Mar 17;379(9820):1056-67. (PMID: 22305766)
Community Ment Health J. 2010 Oct;46(5):474-81. (PMID: 20571877)
Depress Anxiety. 2012 Oct;29(10):906-13. (PMID: 22753313)
Med Care Res Rev. 2007 Aug;64(4):416-30. (PMID: 17684110)
Cochrane Database Syst Rev. 2012 Nov 14;11:CD004851. (PMID: 23152227)
Arch Gen Psychiatry. 2005 Jun;62(6):593-602. (PMID: 15939837)
JAMA. 2005 Jan 19;293(3):311-9. (PMID: 15657324)
Early Interv Psychiatry. 2018 Feb;12(1):45-54. (PMID: 26542332)
Med Care. 2006 May;44(5):398-405. (PMID: 16641657)
Patient Educ Couns. 2006 Nov;63(3):319-27. (PMID: 16872793)
Patient Educ Couns. 2008 Apr;71(1):125-35. (PMID: 18242040)
Implement Sci. 2016 Aug 08;11:114. (PMID: 27502770)
JAMA Intern Med. 2015 Nov;175(11):1761-70. (PMID: 26414670)
Australas Psychiatry. 2008 Oct;16(5):354-8. (PMID: 18665469)
Med J Aust. 2007 Oct 1;187(S7):S68-70. (PMID: 17908032)
Curr Opin Psychiatry. 2008 Nov;21(6):606-12. (PMID: 18852569)
Lancet. 2003 Oct 11;362(9391):1225-30. (PMID: 14568747)
Health Expect. 2003 Jun;6(2):149-59. (PMID: 12752743)
Patient Educ Couns. 2007 Jun;66(3):296-302. (PMID: 17433603)
J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941)
Health Expect. 2015 Dec;18(6):1856-72. (PMID: 25145796)
Patient Educ Couns. 2006 Nov;63(3):314-8. (PMID: 16872794)

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

Date Created: 20161018 Date Completed: 20180522 Latest Revision: 20240603

20240603

PMC5513008

10.1111/hex.12510

27748004