ANTIPSYCHOTIC DECISION AID ACCEPTABILITY: FEEDBACK FROM CLIENTS, FAMILY MEMBERS, AND PHYSICIANS

Monday, October 25, 2010
Sheraton Hall E/F (Sheraton Centre Toronto Hotel)
Anh Thu Bui, MD, California Institute for Mental Health, Palm Springs, CA and Doug DelPaggio, PharmD, MPA, Alameda County Behavioral Health Care Services, Oakland, CA

Purpose: To obtain written and verbal feedback from potential end-users of antipsychotic decision aid materials in public mental health settings.

Method: After a review of the literature focused on shared decision-making, decision support tools and decision aids in mental health, we convened a workgroup of psychiatrists, pharmacologists, and clients and developed initial draft decision aid materials to help clients make decisions about antipsychotic medications.  We developed acceptability surveys for clients, family members, and physicians to obtain written feedback about the format and content of the decision aid materials.  We also conducted group discussions with clients and family members, and individual interviews with physicians at public mental health clinics to obtain verbal feedback and further ideas for improving the decision aid materials.

Result: In summary, we obtained feedback from 14 clients, 7 family members, and 12 physicians from public mental health settings.  Overall, the response is favorable to the use of these decision aid materials.  However, there are mixed responses regarding the content, length, and complexity of the materials that should be presented to clients making decisions about antipsychotic medications.  For example, clients in general favor more information about side effects, but physicians and family members express concern that more information about side effects may function as an inadvertent bias against medications.

Conclusion: By obtaining written feedback with verbal discussions from clients, family members, and physicians, we received valuable advice and ideas on specific information desired by the various stakeholders in developing decision aids on antipsychotic medications.  Overall, this select group of stakeholders supports the use of decision aids in helping clients making decisions about antipsychotic medications.