S45: Improving decision-making about treatment in bipolar II disorder: Pilot of a patient decision-aid.

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By September 26, 2017 No Comments

Authors: Alana Fisher, Josephine Anderson, Louise Sharpe, Vijaya Manicavasagar, Ilona Juraskova

Year: 2017

Event: 2017 TheMHS Conference

Subject: Research & Evaluation Informing Practice,Promotion, Prevention, Early Intervention,Clinical Issues

Type of resource: Conference Presentations and Papers

Abstract: Background and aims. This pilot study aimed to evaluate a decision-support resource (a decision-aid, DA) for patients with BPII making treatment decisions, by obtaining preliminary evidence on its acceptability, feasibility, and safety in a sample of potential end users (patients with BPII and their family).

Methods. The DA booklet was developed in line with International Patient Decision-Aid Standards (IPDAS) and presents evidence-based, unbiased information on medical and psychological options for relapse prevention in BPII. Values clarification exercises assist patients (and their family) to integrate their values and preferences into treatment decisions. Thirty patients with a BPII diagnosis and their family (n = 15) are being recruited via a specialist outpatient clinical facility, and online via relevant mental health agency websites. Participants read through the DA and complete self-report questionnaires assessing DA perceptions, understanding of treatment options, and other aspects of decision-making quality. A follow-up semi-structured telephone interview will elicit more in-depth feedback (n = 45).

Results. Preliminary results will be presented.

Conclusion. Pilot findings will indicate whether patients with BPII and their family consider this DA booklet useful in making an informed treatment decision, that is a decision considering the best available clinical evidence, their treatment preferences and life circumstances.

Learning Objectives
Learning Objective 1: The audience will be presented with preliminary findings evaluating a world-first evidence-based decision-support resource to assist patients with bipolar II disorder to make informed treatment decisions.

Learning Objective 2: As a chronic, relapsing and highly burdensome illness, bipolar II disorder relies heavily on patients implementing a self-management approach of taking prophylactic medications, monitoring symptoms and making behavioural changes in response to symptoms to reduce relapse risk. As such, it is crucial that people diagnosed with this disorder are encouraged to adopt an active role in their illness management as early as possible, from the point of making treatment decisions following diagnosis. The rigorous development and evaluation of evidence-based tools to support shared decision-making in mental health settings has the potential to significantly enhance the management and outcomes of bipolar II disorder and other mental health conditions.

Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder. Journal of Mental Health (Published online 13 January 2017). doi: http://dx.doi.org/10.1080/09638237.2016.1276533
Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. Identifying and addressing barriers to treatment decision-making in bipolar II disorder: Clinicians’ perspective. Australian Psychologist (Published online 14 February 2017) doi:10.1111/ap.12264

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