Effectiveness of a Decision Aid for Antipsychotic Medication Use in Public Mental Health

Mahone, Irma H.

Monday, July 11, 2011

Irma H. Mahone, PhD
School of Nursing, University of Virginia, Charlottesville, VA

Learning Objective 1: 1. The learner will be able to discuss three advantages to using decision aids in mental health.

Learning Objective 2: 2. The learner will be able to identify four good tools to measure engagement and empowerment of persons with serious mental illness.

Purpose: Patient decision aids are used in shared decision making (SDM) as tools that provide information about the options and outcomes and that help to clarify personal preferences. Considering the role of antipsychotic medications in my recovery plan is an electronic, interactive decision aid on antipsychotic medication use that was created over a two-year period for a US federal agency and is now awaiting final clearance before it will be available on the internet. A study was designed to determine the effectiveness of the decision aid to engage and empower individuals with serious mental illness to greater participation in their own treatment plan decisions.

Methods: Orientation sessions will be offered to three stakeholders groups at the public mental health center – prescribers, mental health clinicians, and consumers. Orientation sessions will consist of brief overviews of the decision aid, its self-taught tutorials, auxiliary worksheets, and its unique features, focusing on practical skills in navigating the decision aid and the resulting report. Consumers who volunteer to participate and are randomized to the treatment group will be asked to spend some time on the decision aid a minimum of once every two weeks. Measures will be administered at baseline and again at the three-month and six-month time-points.

Results: Funding is expected in 2011.

Conclusion: This study will achieve the following specific aims: 1. Describe the experience of clients using the decision-aid; 2. Determine the impact of decision-aid use on: patient preparation for decision-making, patient satisfaction with communication, and confidence in decision; 3. Determine patient characteristics that influence the effectiveness of the decision aid in increasing: patients’ knowledge, skill and self-confidence for self-management of chronic condition, and patients’ self-ratings of the quality of health services; and 4. Determine the effect of patient characteristics, patient ratings of provider behaviors, and utilization of services on health outcomes.

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