Right choice, right time: Evaluation of an online decision aid for youth depression. (17th October 2016)

• Record Type: Journal Article
• Authors: Simmons, Magenta B.; Elmes, Aurora; McKenzie, Joanne E.; Trevena, Lyndal; Hetrick, Sarah E.
• Is Part Of: Health expectations. Volume 20:Number 4(2017)
• Page Start: 714
• Page End: 723
• Publication Date: 2016-10-17
• Subjects: adolescents -- depression -- patient decision aids -- shared decision making -- young adults; Medical policy -- Periodicals; Public health -- Periodicals; Health planning -- Periodicals; 362.105
• DOI: 10.1111/hex.12510
• Languages: English
• ISSNs: 1369-6513

Abstract

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.