Shared Decision Making Tool for Antidepressant Choices

mayologoThe choice of antidepressant in primary care can directly affect outcomes and quality of care for patients with depression. Faculty at the Mayo Clinic developed the Depression Medication Choice (DMC) encounter decision aid, designed to help patients and clinicians consider the available antidepressants and the extent to which they improved depression and other issues important to patients.

A tool to help patients with depression make informed decisions about appropriate antidepressants improves the antidepressant decision-making process without extending the length of primary care visits, according to a report in JAMA Internal Medicine. The tool, developed by researchers at the Mayo Clinic in Rochester, Minn., is called Depression Medication Choice (DMC). DMC consists of a series of cards that present general information about antidepressant efficacy and highlight various features of antidepressants—for instance, effects on sleep, sexual issues, and weight gain. The cards are used by the patient with the clinician during the primary care visit.

Mayo researchers conducted a cluster randomized trial of adults with moderate to severe depression considering treatment with an antidepressant. Primary care practices in 10 rural, suburban, and urban primary care practices across Minnesota and Wisconsin were randomly allocated to treatment of depression with or without use of the DMC decision aid. Compared with usual care, use of DMC significantly improved patients’ decisional comfort, knowledge, satisfaction, and involvement. It also improved clinicians’ decisional comfort. There were no differences in encounter duration, medication adherence, or improvement of depression control between study arms.

Source: JAMA Internal Medicine