Shared Decision Making for Antidepressants in Primary Care: A Cluster Randomized Trial.

Abstract:

IMPORTANCE:For antidepressants, the translation of evidence of comparative effectiveness into practice is suboptimal. This deficit directly affects outcomes and quality of care for patients with depression. To overcome this problem, we developed the Depression Medication Choice (DMC) encounter decision aid, designed to help patients and clinicians consider the available antidepressants and the extent to which they improved depression and other issues important to patients. OBJECTIVE:Estimate the effect of DMC on quality of the decision-making process and depression outcomes. DESIGN, SETTING, AND PARTICIPANTS:We conducted a cluster randomized trial of adults with moderate to severe depression considering treatment with an antidepressant. Primary care practices in 10 rural, suburban, and urban primary care practices across Minnesota and Wisconsin were randomly allocated to treatment of depression with or without use of the DMC decision aid. INTERVENTION:Depression Medication Choice, a series of cards, each highlighting the effect of the available options on an issue of importance to patients for use during face-to-face consultations. MAIN OUTCOMES AND MEASURES:Decision-making quality as judged by patient knowledge and involvement in decision making, patient and clinician decisional comfort (Decisional Conflict Scale) and satisfaction, encounter duration, medication adherence, depression symptoms, and the Patient Health Questionnaire for depression (PHQ-9). RESULTS:We enrolled 117 clinicians and 301 patients (67% women; mean [SD] age, 44 [15] years; mean [SD] PHQ-9 score, 15 [4]) into the trial. Compared with usual care (UC), use of DMC significantly improved patients' decisional comfort (DMC, 80% vs UC, 75%; P = .02), knowledge (DMC, 65% vs UC, 56%; P = .03), satisfaction (risk ratio [RR], from 1.25 [P = .81] to RR, 2.4 [P = .002] depending on satisfaction domain), and involvement (DMC, 47% vs UC, 33%; P<.001). It also improved clinicians' decisional comfort (DMC, 80% vs UC, 68%; P < .001) and satisfaction (RR, 1.64; P = .02). There were no differences in encounter duration, medication adherence, or improvement of depression control between arms. CONCLUSIONS AND RELEVANCE:The DMC decision aid helped primary care clinicians and patients with moderate to severe depression select antidepressants together, improving the decision-making process without extending the visit. On the other hand, DMC had no discernible effect on medication adherence or depression outcomes. By translating comparative effectiveness into patient-centered care, use of DMC improved the quality of primary care for patients with depression. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT01502891.

journal_name

JAMA Intern Med

journal_title

JAMA internal medicine

authors

LeBlanc A,Herrin J,Williams MD,Inselman JW,Branda ME,Shah ND,Heim EM,Dick SR,Linzer M,Boehm DH,Dall-Winther KM,Matthews MR,Yost KJ,Shepel KK,Montori VM

doi

10.1001/jamainternmed.2015.5214

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

1761-70

issue

11

eissn

2168-6106

issn

2168-6114

pii

2443367

journal_volume

175

pub_type

杂志文章,随机对照试验
  • Comparison of Male vs Female Resident Milestone Evaluations by Faculty During Emergency Medicine Residency Training.

    abstract:Importance:Although implicit bias in medical training has long been suspected, it has been difficult to study using objective measures, and the influence of sex and gender in the evaluation of medical trainees is unknown. The emergency medicine (EM) milestones provide a standardized framework for longitudinal resident ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2016.9616

    authors: Dayal A,O'Connor DM,Qadri U,Arora VM

    更新日期:2017-05-01 00:00:00

  • Effect of a Patient and Clinician Communication-Priming Intervention on Patient-Reported Goals-of-Care Discussions Between Patients With Serious Illness and Clinicians: A Randomized Clinical Trial.

    abstract:Importance:Clinician communication about goals of care is associated with improved patient outcomes and reduced intensity of end-of-life care, but it is unclear whether interventions can improve this communication. Objective:To evaluate the efficacy of a patient-specific preconversation communication-priming intervent...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1001/jamainternmed.2018.2317

    authors: Curtis JR,Downey L,Back AL,Nielsen EL,Paul S,Lahdya AZ,Treece PD,Armstrong P,Peck R,Engelberg RA

    更新日期:2018-07-01 00:00:00

  • Outpatient care patterns and organizational accountability in Medicare.

    abstract:IMPORTANCE:Fostering accountability in the Medicare Accountable Care Organization (ACO) programs may be challenging because traditional Medicare beneficiaries have unrestricted choice of health care providers, are attributed to ACOs based on utilization, and often receive fragmented care. OBJECTIVE:To measure 3 relate...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2014.1073

    authors: McWilliams JM,Chernew ME,Dalton JB,Landon BE

    更新日期:2014-06-01 00:00:00

  • The Effect of Primary Care Provider Turnover on Patient Experience of Care and Ambulatory Quality of Care.

    abstract:IMPORTANCE:Primary care provider (PCP) turnover is common and can disrupt patient continuity of care. Little is known about the effect of PCP turnover on patient care experience and quality of care. OBJECTIVE:To measure the effect of PCP turnover on patient experiences of care and ambulatory care quality. DESIGN, SET...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2015.1853

    authors: Reddy A,Pollack CE,Asch DA,Canamucio A,Werner RM

    更新日期:2015-07-01 00:00:00

  • Assessment of Pregabalin Postapproval Trials and the Suggestion of Efficacy for New Indications: A Systematic Review.

    abstract:Importance:After a drug receives regulatory approval, researchers often pursue small, underpowered trials, called exploratory trials, aimed at testing additional indications. If favorable early findings from exploratory trials are not promptly followed by confirmatory trials, then physicians, patients, and payers can b...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2018.5705

    authors: Federico CA,Wang T,Doussau A,Mogil JS,Fergusson D,Kimmelman J

    更新日期:2019-01-01 00:00:00

  • National Registry Data and Record Linkage to Inform Postmarket Surveillance of Prosthetic Aortic Valve Models Over 15 Years.

    abstract:Importance:Postmarket evidence generation for medical devices is important yet limited for prosthetic aortic valve devices in the United Kingdom. Objective:To identify prosthetic aortic valve models that display unexpected patterns of mortality or reintervention using routinely collected national registry data and rec...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2016.6936

    authors: Hickey GL,Bridgewater B,Grant SW,Deanfield J,Parkinson J,Bryan AJ,Dalrymple-Hay M,Moat N,Buchan I,Dunning J

    更新日期:2017-01-01 00:00:00

  • Analysis of Computed Tomography Radiation Doses Used for Lung Cancer Screening Scans.

    abstract:Importance:The American College of Radiology (ACR) has recognized the importance of minimizing radiation doses used for lung cancer screening (LCS) computed tomography (CT). However, without standard protocols, doses could still be unnecessarily high, reducing screening margin of benefit. Objective:To characterize LCS...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2019.3893

    authors: Demb J,Chu P,Yu S,Whitebird R,Solberg L,Miglioretti DL,Smith-Bindman R

    更新日期:2019-09-23 00:00:00

  • Early palliative care in advanced lung cancer: a qualitative study.

    abstract::BACKGROUND Early ambulatory palliative care (PC) is an emerging practice, and its key elements have not been defined. We conducted a qualitative analysis of data from a randomized controlled trial that demonstrated improved quality of life, mood, and survival in patients with newly diagnosed metastatic non-small cell ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2013.1874

    authors: Yoong J,Park ER,Greer JA,Jackson VA,Gallagher ER,Pirl WF,Back AL,Temel JS

    更新日期:2013-02-25 00:00:00

  • Evaluating the Association of Clinical Characteristics With Neutralizing Antibody Levels in Patients Who Have Recovered From Mild COVID-19 in Shanghai, China.

    abstract:Importance:The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens global public health. The association between clinical characteristics of the virus and neutralizing antibodies (NAbs) against this virus have not been well studied. Objective:To...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2020.4616

    authors: Wu F,Liu M,Wang A,Lu L,Wang Q,Gu C,Chen J,Wu Y,Xia S,Ling Y,Zhang Y,Xun J,Zhang R,Xie Y,Jiang S,Zhu T,Lu H,Wen Y,Huang J

    更新日期:2020-10-01 00:00:00

  • Association Between Electronic Cigarette Use and Smoking Reduction in France.

    abstract:Importance:The electronic cigarette (EC) has become popular among smokers who wish to reduce their tobacco use levels or quit smoking, but its effectiveness as a cessation aid is uncertain. Objective:To examine the association of regular EC use with the number of cigarettes smoked per day, smoking cessation among curr...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2019.1483

    authors: Gomajee R,El-Khoury F,Goldberg M,Zins M,Lemogne C,Wiernik E,Lequy-Flahault E,Romanello L,Kousignian I,Melchior M

    更新日期:2019-07-15 00:00:00

  • Observational modeling of strict vs conventional blood pressure control in patients with chronic kidney disease.

    abstract:IMPORTANCE:The effect of strict blood pressure control on clinical outcomes in patients with chronic kidney disease (CKD) is unclear. OBJECTIVE:To compare the outcomes associated with a treated systolic blood pressure (SBP) of less than 120 mm Hg vs those associated with the currently recommended SBP of less than 140 ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2014.3279

    authors: Kovesdy CP,Lu JL,Molnar MZ,Ma JZ,Canada RB,Streja E,Kalantar-Zadeh K,Bleyer AJ

    更新日期:2014-09-01 00:00:00

  • Cognitive function and brain structure in persons with type 2 diabetes mellitus after intensive lowering of blood pressure and lipid levels: a randomized clinical trial.

    abstract:IMPORTANCE:Persons with type 2 diabetes mellitus (T2DM) are at increased risk for decline in cognitive function, reduced brain volume, and increased white matter lesions in the brain. Poor control of blood pressure (BP) and lipid levels are risk factors for T2DM-related cognitive decline, but the effect of intensive tr...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1001/jamainternmed.2013.13656

    authors: Williamson JD,Launer LJ,Bryan RN,Coker LH,Lazar RM,Gerstein HC,Murray AM,Sullivan MD,Horowitz KR,Ding J,Marcovina S,Lovato L,Lovato J,Margolis KL,Davatzikos C,Barzilay J,Ginsberg HN,Linz PE,Miller ME,Action to Contr

    更新日期:2014-03-01 00:00:00

  • Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation.

    abstract:Importance:Previous studies have shown that medical student mistreatment is common. However, few data exist to date describing how the prevalence of medical student mistreatment varies by student sex, race/ethnicity, and sexual orientation. Objective:To examine the association between mistreatment and medical student ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2020.0030

    authors: Hill KA,Samuels EA,Gross CP,Desai MM,Sitkin Zelin N,Latimore D,Huot SJ,Cramer LD,Wong AH,Boatright D

    更新日期:2020-05-01 00:00:00

  • Influence of the timing of antiretroviral therapy on the potential for normalization of immune status in human immunodeficiency virus 1-infected individuals.

    abstract:IMPORTANCE:In individuals with human immunodeficiency virus 1 (HIV-1) infection who are receiving antiretroviral therapy (ART), factors that promote full immune recovery are not well characterized. OBJECTIVE:To investigate the influence of the timing of ART relative to HIV-1 infection on normalization of CD4+ T-cell c...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1001/jamainternmed.2014.4010

    authors: Okulicz JF,Le TD,Agan BK,Camargo JF,Landrum ML,Wright E,Dolan MJ,Ganesan A,Ferguson TM,Smith DM,Richman DD,Little SJ,Clark RA,He W,Ahuja SK

    更新日期:2015-01-01 00:00:00

  • Receipt of Antibiotics in Hospitalized Patients and Risk for Clostridium difficile Infection in Subsequent Patients Who Occupy the Same Bed.

    abstract:Objective:To assess whether receipt of antibiotics by prior hospital bed occupants is associated with increased risk for CDI in subsequent patients who occupy the same bed. Design, Setting, and Participants:This is a retrospective cohort study of adult patients hospitalized in any 1 of 4 facilities between 2010 and 20...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2016.6193

    authors: Freedberg DE,Salmasian H,Cohen B,Abrams JA,Larson EL

    更新日期:2016-12-01 00:00:00

  • Dietary sodium content, mortality, and risk for cardiovascular events in older adults: the Health, Aging, and Body Composition (Health ABC) Study.

    abstract:IMPORTANCE:Additional information is needed about the role of dietary sodium on health outcomes in older adults. OBJECTIVE:To examine the association between dietary sodium intake and mortality, incident cardiovascular disease (CVD), and incident heart failure (HF) in older adults. DESIGN, SETTING, AND PARTICIPANTS:W...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2014.6278

    authors: Kalogeropoulos AP,Georgiopoulou VV,Murphy RA,Newman AB,Bauer DC,Harris TB,Yang Z,Applegate WB,Kritchevsky SB

    更新日期:2015-03-01 00:00:00

  • Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis.

    abstract:IMPORTANCE:Adherence to long-term therapies in chronic disease is poor. Traditional interventions to improve adherence are complex and not widely effective. Mobile telephone text messaging may be a scalable means to support medication adherence. OBJECTIVES:To conduct a meta-analysis of randomized clinical trials to as...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1001/jamainternmed.2015.7667

    authors: Thakkar J,Kurup R,Laba TL,Santo K,Thiagalingam A,Rodgers A,Woodward M,Redfern J,Chow CK

    更新日期:2016-03-01 00:00:00

  • Appropriate use and clinical impact of transthoracic echocardiography.

    abstract:IMPORTANCE:Transthoracic echocardiography (TTE) accounts for almost half of all cardiac imaging services and is a widely available and versatile tool. Appropriate use criteria (AUC) for echocardiography were developed to improve patient care and health outcomes. Prior studies have shown that most TTEs are appropriate b...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2013.8972

    authors: Matulevicius SA,Rohatgi A,Das SR,Price AL,DeLuna A,Reimold SC

    更新日期:2013-09-23 00:00:00

  • Effectiveness of Combined Behavioral and Drug Therapy for Overactive Bladder Symptoms in Men: A Randomized Clinical Trial.

    abstract:Importance:First-line behavioral and drug therapies for overactive bladder (OAB) symptoms in men are effective but not usually curative. Objective:To determine whether combining behavioral and drug therapies improves outcomes compared with each therapy alone for OAB in men and to compare 3 sequences for implementing c...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1001/jamainternmed.2019.6398

    authors: Burgio KL,Kraus SR,Johnson TM 2nd,Markland AD,Vaughan CP,Li P,Redden DT,Goode PS

    更新日期:2020-03-01 00:00:00

  • Consequences of false-positive screening mammograms.

    abstract:IMPORTANCE:False-positive mammograms, a common occurrence in breast cancer screening programs, represent a potential screening harm that is currently being evaluated by the US Preventive Services Task Force. OBJECTIVE:To measure the effect of false-positive mammograms on quality of life by measuring personal anxiety, ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2014.981

    authors: Tosteson AN,Fryback DG,Hammond CS,Hanna LG,Grove MR,Brown M,Wang Q,Lindfors K,Pisano ED

    更新日期:2014-06-01 00:00:00

  • Quasi-Experimental Evaluation of the Effectiveness of a Large-Scale Readmission Reduction Program.

    abstract:IMPORTANCE:Feasibility, effectiveness, and sustainability of large-scale readmission reduction efforts are uncertain. The Greater New Haven Coalition for Safe Transitions and Readmission Reductions was funded by the Center for Medicare & Medicaid Services (CMS) to reduce readmissions among all discharged Medicare fee-f...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2016.0833

    authors: Jenq GY,Doyle MM,Belton BM,Herrin J,Horwitz LI

    更新日期:2016-05-01 00:00:00

  • Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus.

    abstract:IMPORTANCE:Older patients with diabetes mellitus receiving medical treatment whose blood pressure (BP) or blood glucose level are potentially dangerously low are rarely deintensified. Given the established risks of low blood pressure and blood glucose, this is a major opportunity to decrease medication harm. OBJECTIVE...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2015.5110

    authors: Sussman JB,Kerr EA,Saini SD,Holleman RG,Klamerus ML,Min LC,Vijan S,Hofer TP

    更新日期:2015-12-01 00:00:00

  • Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial.

    abstract:Importance:Urinary stone disease is a common presentation in the emergency department, and α-adrenergic receptor blockers, such as tamsulosin, are commonly used to facilitate stone passage. Objective:To determine if tamsulosin promotes the passage of urinary stones within 28 days among emergency department patients. ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1001/jamainternmed.2018.2259

    authors: Meltzer AC,Burrows PK,Wolfson AB,Hollander JE,Kurz M,Kirkali Z,Kusek JW,Mufarrij P,Jackman SV,Brown J

    更新日期:2018-08-01 00:00:00

  • Treatment of Vitamin D Insufficiency in Postmenopausal Women: A Randomized Clinical Trial.

    abstract:IMPORTANCE:Experts debate optimal 25-hydroxyvitamin D (25[OH]D) levels for musculoskeletal health. OBJECTIVE:To compare the effects of placebo, low-dose cholecalciferol, and high-dose cholecalciferol on 1-year changes in total fractional calcium absorption, bone mineral density, Timed Up and Go and five sit-to-stand t...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1001/jamainternmed.2015.3874

    authors: Hansen KE,Johnson RE,Chambers KR,Johnson MG,Lemon CC,Vo TN,Marvdashti S

    更新日期:2015-10-01 00:00:00

  • Duration of menopausal vasomotor symptoms over the menopause transition.

    abstract:IMPORTANCE:The expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments. OBJECTIVES:To determine total duration of frequent VMS (≥ 6 days in the previous 2 weeks) (hereafter total VMS duration) during the menopausal transition, to quantify how long frequ...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1001/jamainternmed.2014.8063

    authors: Avis NE,Crawford SL,Greendale G,Bromberger JT,Everson-Rose SA,Gold EB,Hess R,Joffe H,Kravitz HM,Tepper PG,Thurston RC,Study of Women's Health Across the Nation.

    更新日期:2015-04-01 00:00:00

  • Estimation of Excess Deaths Associated With the COVID-19 Pandemic in the United States, March to May 2020.

    abstract:Importance:Efforts to track the severity and public health impact of coronavirus disease 2019 (COVID-19) in the United States have been hampered by state-level differences in diagnostic test availability, differing strategies for prioritization of individuals for testing, and delays between testing and reporting. Evalu...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2020.3391

    authors: Weinberger DM,Chen J,Cohen T,Crawford FW,Mostashari F,Olson D,Pitzer VE,Reich NG,Russi M,Simonsen L,Watkins A,Viboud C

    更新日期:2020-10-01 00:00:00

  • The Business Case for Investing in Physician Well-being.

    abstract:Importance:Widespread burnout among physicians has been recognized for more than 2 decades. Extensive evidence indicates that physician burnout has important personal and professional consequences. Observations:A lack of awareness regarding the economic costs of physician burnout and uncertainty regarding what organiz...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2017.4340

    authors: Shanafelt T,Goh J,Sinsky C

    更新日期:2017-12-01 00:00:00

  • Acupuncture as Adjunctive Therapy for Chronic Stable Angina: A Randomized Clinical Trial.

    abstract:Importance:The effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina are uncertain. Objective:To investigate the efficacy and safety of acupuncture as adjunctive therapy to antianginal therapies in reducing frequency of angina attacks in patients with chronic s...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2019.2407

    authors: Zhao L,Li D,Zheng H,Chang X,Cui J,Wang R,Shi J,Fan H,Li Y,Sun X,Zhang F,Wu X,Liang F

    更新日期:2019-07-29 00:00:00

  • Sildenafil use and increased risk of incident melanoma in US men: a prospective cohort study.

    abstract:IMPORTANCE:The RAS/RAF/mitogen-activated protein kinase and extracellular signal-regulated kinase (ERK) kinase/ERK cascade plays a crucial role in melanoma cell proliferation and survival. Sildenafil citrate (Viagra) is a phosphodiesterase (PDE) 5A inhibitor commonly used for erectile dysfunction. Recent studies have s...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2014.594

    authors: Li WQ,Qureshi AA,Robinson KC,Han J

    更新日期:2014-06-01 00:00:00

  • Sodium Reduction in US Households' Packaged Food and Beverage Purchases, 2000 to 2014.

    abstract:Importance:Initiatives to reduce sodium in packaged foods have been launched in the United States, yet corresponding changes in the amount of sodium that US households obtain from packaged foods have not been evaluated, to our knowledge. Objective:To assess 15-year changes in the amount of sodium that US households ac...

    journal_title:JAMA internal medicine

    pub_type: 杂志文章

    doi:10.1001/jamainternmed.2017.1407

    authors: Poti JM,Dunford EK,Popkin BM

    更新日期:2017-07-01 00:00:00