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Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis
BACKGROUND: People with psychosis struggle with decisions about their use of antipsychotics. They often want to reduce the dose or stop, while facing uncertainty regarding the effects these decisions will have on their treatment and recovery. They may also fear raising this issue with clinicians. Th...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963160/ https://www.ncbi.nlm.nih.gov/pubmed/29788933 http://dx.doi.org/10.1186/s12888-018-1707-x |
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author | Zisman-Ilani, Yaara Shern, David Deegan, Patricia Kreyenbuhl, Julie Dixon, Lisa Drake, Robert Torrey, William Mishra, Manish Gorbenko, Ksenia Elwyn, Glyn |
author_facet | Zisman-Ilani, Yaara Shern, David Deegan, Patricia Kreyenbuhl, Julie Dixon, Lisa Drake, Robert Torrey, William Mishra, Manish Gorbenko, Ksenia Elwyn, Glyn |
author_sort | Zisman-Ilani, Yaara |
collection | PubMed |
description | BACKGROUND: People with psychosis struggle with decisions about their use of antipsychotics. They often want to reduce the dose or stop, while facing uncertainty regarding the effects these decisions will have on their treatment and recovery. They may also fear raising this issue with clinicians. The purpose of this study was to develop and test a shared decision making (SDM) tool to support patients and clinicians in making decisions about antipsychotics. METHODS: A diverse editorial research team developed an Encounter Decision Aid (EDA) for patients and clinicians to use as part of the psychiatric consultation. The EDA was tested using 24 semistructured interviews with participants representing six stakeholder groups: patients with first-episode psychosis, patients with long-term psychosis, family members, psychiatrists, mental health counselors, and administrators. We used inductive and deductive coding of interview transcripts to identify points to revise within three domains: general impression and purpose of the EDA; suggested changes to the content, wording, and appearance; and usability and potential contribution to the psychiatric consultation. RESULTS: An EDA was developed in an iterative process that yielded evidence-based answers to five frequently asked questions about antipsychotic medications. Patients with long-term psychosis and mental health counselors suggested more changes and revisions than patients with first-episode psychosis and psychiatrists. Family members suggested more revisions to the answers about potential risks of stopping or adjusting antipsychotics than other respondents. CONCLUSIONS: The EDA was perceived as potentially useful and feasible in psychiatric routine care, especially if presented during the consultation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-018-1707-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5963160 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59631602018-06-25 Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis Zisman-Ilani, Yaara Shern, David Deegan, Patricia Kreyenbuhl, Julie Dixon, Lisa Drake, Robert Torrey, William Mishra, Manish Gorbenko, Ksenia Elwyn, Glyn BMC Psychiatry Research Article BACKGROUND: People with psychosis struggle with decisions about their use of antipsychotics. They often want to reduce the dose or stop, while facing uncertainty regarding the effects these decisions will have on their treatment and recovery. They may also fear raising this issue with clinicians. The purpose of this study was to develop and test a shared decision making (SDM) tool to support patients and clinicians in making decisions about antipsychotics. METHODS: A diverse editorial research team developed an Encounter Decision Aid (EDA) for patients and clinicians to use as part of the psychiatric consultation. The EDA was tested using 24 semistructured interviews with participants representing six stakeholder groups: patients with first-episode psychosis, patients with long-term psychosis, family members, psychiatrists, mental health counselors, and administrators. We used inductive and deductive coding of interview transcripts to identify points to revise within three domains: general impression and purpose of the EDA; suggested changes to the content, wording, and appearance; and usability and potential contribution to the psychiatric consultation. RESULTS: An EDA was developed in an iterative process that yielded evidence-based answers to five frequently asked questions about antipsychotic medications. Patients with long-term psychosis and mental health counselors suggested more changes and revisions than patients with first-episode psychosis and psychiatrists. Family members suggested more revisions to the answers about potential risks of stopping or adjusting antipsychotics than other respondents. CONCLUSIONS: The EDA was perceived as potentially useful and feasible in psychiatric routine care, especially if presented during the consultation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-018-1707-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-22 /pmc/articles/PMC5963160/ /pubmed/29788933 http://dx.doi.org/10.1186/s12888-018-1707-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zisman-Ilani, Yaara Shern, David Deegan, Patricia Kreyenbuhl, Julie Dixon, Lisa Drake, Robert Torrey, William Mishra, Manish Gorbenko, Ksenia Elwyn, Glyn Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title | Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title_full | Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title_fullStr | Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title_full_unstemmed | Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title_short | Continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
title_sort | continue, adjust, or stop antipsychotic medication: developing and user testing an encounter decision aid for people with first-episode and long-term psychosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963160/ https://www.ncbi.nlm.nih.gov/pubmed/29788933 http://dx.doi.org/10.1186/s12888-018-1707-x |
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