Engaging psychiatric patients in antipsychotic choice: User testing of a shared decision making tool
Yaara Zisman Ilani
Dartmouth College
Yaara Zisman-Ilani is a Rothschild Postdoctoral Fellow at The Dartmouth Institute for Health Policy & Clinical Practice at Dartmouth College. She is a psychologist (M.A. Summa Cum Laude) and a mental health researcher (Ph.D.) with experience and interest in conducting translational research to promote recovery, community inclusion, and psychiatric rehabilitation of people with serious mental illnesses in both the clinical and community setting. Yaara employs shared decision making models, and patient-centered communication methods to facilitate patient engagement and motivation for change in the mental health setting. In addition, Yaara is an experienced methodologist with a rich background in psychometric studies, statistics, and evaluation research. She has been involved in the development, design, implementation, and analysis of studies and trials to evaluate mental health interventions and tools for clinicians and people with serious mental illnesses.
Abstract
Introduction:People who have experienced a psychotic episode and recovered by using antipsychotic medication face an important dilemma: should they continue taking medication at the same does or adjust the dose whilst... [ view full abstract ]
Introduction:
People who have experienced a psychotic episode and recovered by using antipsychotic medication face an important dilemma: should they continue taking medication at the same does or adjust the dose whilst monitoring their symptoms. This dilemma is the result of some uncertainty about the appropriate treatment strategy for long-term management of psychosis.
Engaging patients in a shared decision-making (SDM) process is increasingly the preferred approach for making healthcare decisions when more than one reasonable option is available and to improve health care delivery. The present project focuses on a user testing of a new SDM tool that we developed and designed to stimulate more collaborative decision making—namely a comparison table called the Option GridTM decision aid. We evaluated the understandability, usability and acceptability of the new tool from different perspectives in healthcare delivery.
Methods:
We employed a qualitative design using semi-structured cognitive interviews with 24 interviewees: 6 patients with chronic psychosis (schizophrenia), 5 First Episode Psychosis patients, 5 family members, 6 clinicians (psychiatrists and mental health counselors), and 2 healthcare administrators. An inductive thematic analysis had been conducted, reviewed and discussed by our research team. The Option Grid was refined based on these analysis and feedback.
Results and implications:
The results emphasize the importance of insight to illness and attention to language choice. The present tool can change the reality around care by: 1) introducing the likelihood and eventuality of stopping medication as part of the psychiatric consultation
2) Underline that stopping medications is one possible option and it is important to do it safely together with clinician and caregiver
3) Helps make the dilemma and decision-making ”normal” and acceptable routine instead of secret
Authors
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Yaara Zisman Ilani
(Dartmouth College)
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Glyn Elwyn
(Dartmouth College)
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David Shern
(National Association of State Mental Health Program Directors)
Topic Area
Shared decision making and patient-reported outcomes
Session
AS-2B » Abstract Slams: Shared-Decision Making (13:30 - Friday, 5th May, Salons 6, 7, & 8)
Presentation Files
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