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Published Online: 13 March 2024

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

Yaara Zisman-Ilani, Ph.D., M.A. [email protected], Morgan Parker, M.Sc., Elizabeth C. Thomas, Ph.D., John Suarez, M.A., Irene Hurford, M.D., Andrea Bowen, M.D., Monica Calkins, Ph.D., Patricia Deegan, Ph.D., Ilana Nossel, M.D., and Lisa B. Dixon, M.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 8
https://doi.org/10.1176/appi.ps.20230230
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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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Information & Authors

Information

Published In

Go to Psychiatric Services
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Psychiatric Services
Volume 75 • Number 8 • August 01, 2024
Pages: 807 - 811
PubMed: 38477836

History

Received: 16 May 2023
Revision received: 20 December 2023
Accepted: 28 December 2023
Published online: 13 March 2024
Published in print: August 01, 2024

Keywords

  1. Psychosis
  2. Schizophrenia
  3. Shared decision making
  4. Decision aid
  5. Randomized controlled trial
  6. Antipsychotic medications

Authors

Details

Yaara Zisman-Ilani, Ph.D., M.A. [email protected]
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Morgan Parker, M.Sc.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Elizabeth C. Thomas, Ph.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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John Suarez, M.A.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Irene Hurford, M.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Andrea Bowen, M.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Monica Calkins, Ph.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Patricia Deegan, Ph.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Ilana Nossel, M.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Lisa B. Dixon, M.D.
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani, Thomas); Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani); New York State Psychiatric Institute, New York City (Parker, Nossel, Dixon); Institute on Disabilities, College of Education and Human Development, Temple University, Philadelphia (Suarez); Psychosis Education, Assessment, Care and Empowerment, Pennsylvania Early Intervention Center, Philadelphia (Hurford, Bowen); Pennsylvania Early Intervention Center/HeadsUp and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Calkins); Pat Deegan, Ph.D. & Associates, L.L.C., Byfield, Massachusetts (Deegan); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Nossel, Dixon).
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Notes

Send correspondence to Dr. Zisman-Ilani ([email protected]).

Competing Interests

Dr. Zisman-Ilani is a member of the Patient-Centered Outcomes Research Institute’s Advisory Panel on Clinical Effectiveness and Decision Science. The other authors report no financial relationships with commercial interests. Dr. Dixon is editor of Psychiatric Services. Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript.

Funding Information

The views in this report represent the opinions of the authors and not necessarily those of the Patient-Centered Outcomes Research Institute.

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