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

Psychiatr Serv. 2024 Aug 1;75(8):807-811. doi: 10.1176/appi.ps.20230230. Epub 2024 Mar 13.

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.

Keywords: Antipsychotic medications; Decision aid; Psychosis; Randomized controlled trial; Schizophrenia; Shared decision making.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antipsychotic Agents* / therapeutic use
  • Community Mental Health Services*
  • Decision Making, Shared
  • Decision Support Techniques*
  • Feasibility Studies*
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Psychotic Disorders* / drug therapy
  • Young Adult

Substances

  • Antipsychotic Agents