Usability and Feasibility of the Antipsychotic Medication Decision Aid in a Community Program for First-Episode Psychosis.

IF 3.3 3区医学 Q1 HEALTH POLICY & SERVICES Psychiatric services Pub Date : 2024-08-01 Epub Date: 2024-03-13 DOI:10.1176/appi.ps.20230230

Yaara Zisman-Ilani, Morgan Parker, Elizabeth C Thomas, John Suarez, Irene Hurford, Andrea Bowen, Monica Calkins, Patricia Deegan, Ilana Nossel, Lisa B Dixon

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Abstract

Objective: Although antipsychotic medications are considered first-line treatment for psychosis, rates of discontinuation and nonadherence are high, and debate persists about their use. This pilot study aimed to explore the usability, feasibility, and potential impact of a shared decision making (SDM) intervention, the Antipsychotic Medication Decision Aid (APM-DA), for decisions about use of antipsychotic medications.

Methods: A pilot randomized controlled trial was conducted with 17 participants in a first-episode psychosis program. Nine participants received the APM-DA, and eight received usual care.

Results: After their appointments, intervention group participants had less decisional conflict and greater satisfaction with decisions than control group participants had. Use of the APM-DA did not increase appointment length. Comparison of the intervention outcomes with the control outcomes was limited because of the small sample.

Conclusions: The results support the feasibility and usability of an SDM process via the use of the APM-DA in routine community psychosis care.

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抗精神病药物治疗决策辅助工具在首发精神病社区项目中的可用性和可行性。

目的：尽管抗精神病药物被认为是治疗精神病的一线药物，但其停药率和不依从率都很高，而且关于其使用的争论也一直存在。本试验研究旨在探讨共同决策（SDM）干预措施--抗精神病药物治疗决策辅助工具（APM-DA）--在决定是否使用抗精神病药物时的可用性、可行性和潜在影响：方法：我们对首次发病的精神病患者项目中的 17 名参与者进行了随机对照试验。九名参与者接受了 APM-DA，八名参与者接受了常规护理：结果：与对照组参与者相比，干预组参与者在预约后的决策冲突更少，对决策的满意度更高。APM-DA 的使用并未增加预约时间。由于样本较少，干预结果与对照结果的比较受到了限制：结果支持在常规社区精神病护理中使用 APM-DA 进行 SDM 流程的可行性和可用性。

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来源期刊

Psychiatric services 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.80

自引率

7.90%

发文量

295

审稿时长

3-8 weeks

期刊介绍： Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.