Tuesday, October 21, 2014: 11:00 AM

Elizabeth Austin, MPH1, Abbey Hoffman, MS1, Molly Finnerty, MD1, Edith Kealey, Ph.D.1, Xiaojing Hu, MS2, Florence LaGamma, MSW1, Rachael Steimnitz, MPH1, Krithika Rajagopalan, Ph.D.3, Emily Leckman-Westin, Ph.D.2 and Erica Van De Wal, MA4, (1)New York State Office of Mental Health, New York, NY, (2)New York State Office of Mental Health, Albany, NY, (3)Sunovion Pharmaceuticals Inc., Marlborough, MA, (4)NYS Office of Mental Health / NYS Psychiatric Institute, New York, NY
Purpose: As mental health practice continues to anchor itself in patient centered methods of care, it is increasing valuable to understand patients’ preferences and perceptions of the treatments they engage in. Recent studies suggest that patients’ use of mental health medication is often intermittent, and in parallel, their use of alternative forms of medicine is rising.  However little data is available about the extent to which these topics are included in traditional medical dialogues. MyPSYCKES is a web-based shared decision making program that patients use before their appointment. We investigated patients’ answers to MyPSYCKES questions about medication concerns and medication alternatives in particular. 

Method: We implemented MyPSYCKES in eight diverse mental health clinics in New York State and extracted response data for each patient’s first time use of the program. We then investigated patterns of concern around patients who endorsed an interest in exploring alternative therapies or strategies in comparison with other medication concerns. 

Result: A total of 963 patients used the MyPSYCKES application. 28.45% (N=274) of patients reported that they were exploring alternative strategies.  Among those, 30.29% explicitly cited exploring natural or cultural healing methods, 21.90% cited an interest in stopping their medication, and 10.95% cited exploring only taking medication when they are having a difficult time. Among this subset of patients (N=274), 74.82% also answered that they had concerns about how helpful their medications were. 65.33% had concerns about side effects, and 66.42% were concerned about how their medications were affecting their health. Additionally, 43.80% of patients cited concerning fears, 38.32% of patients cited concerning beliefs, and 44.16% cited trouble finding motivation to take medications in addition to their exploration of alternatives. 

Conclusion: 28.45% of patients stated that they were exploring alternative strategies to taking their medication. The large majority of these patients were also concerned about the effectiveness of their medications, which validates previous findings that predict use of alternative therapies, and were also twice as likely to endorse fears (43.80% vs. 21.60%), conflicting beliefs (38.32% vs. 15.37%), or trouble finding motivation (44.16% vs. 22.64%) as concerns that impacted their use of mental health medication. In order to support strong therapeutic alliances and patient centered care, it will be important for practitioners to understand patients’ reasoning and preferences for exploring alternatives.