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      Development of a Strategic Tool for Shared Decision-Making in the Use of Antidepressants among Patients with Major Depressive Disorder: A Focus Group Study

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          Abstract

          Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM in the use of antidepressants among patients with major depressive disorder. Nineteen doctors and 11 major depressive disorder patients who are involved in psychiatric outpatient clinic appointments were purposively selected and recruited to participate in one of six focus groups in a large teaching hospital in Malaysia. Focus groups were transcribed verbatim and analyzed using a thematic approach to identify current views on providing information needed for SDM practice towards its implementation in near future. Patients’ and doctors’ views were organized into six major themes, which are; summary of treatment options, correct ways of taking medication, potential side effects of treatments related to patients, sharing of case study related to the treatment options, cost of treatment options, and input from pharmacist. The information may be included in the SDM tool which can be useful to inform further research efforts and developments that contribute towards the successful implementation of SDM into clinical practice.

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          Most cited references42

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          Global burden of depressive disorders in the year 2000.

          The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. To present the new estimates of depression burden for the year 2000. DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. These data on the burden of depression worldwide represent a major public health problem that affects patients and society.
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            Evidence-based health policy--lessons from the Global Burden of Disease Study.

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              Using focus groups in medical education research: AMEE Guide No. 91.

              Qualitative research methodology has become an established part of the medical education research field. A very popular data-collection technique used in qualitative research is the "focus group". Focus groups in this Guide are defined as "… group discussions organized to explore a specific set of issues … The group is focused in the sense that it involves some kind of collective activity … crucially, focus groups are distinguished from the broader category of group interview by the explicit use of the group interaction as research data" (Kitzinger 1994, p. 103). This Guide has been designed to provide people who are interested in using focus groups with the information and tools to organize, conduct, analyze and publish sound focus group research within a broader understanding of the background and theoretical grounding of the focus group method. The Guide is organized as follows: Firstly, to describe the evolution of the focus group in the social sciences research domain. Secondly, to describe the paradigmatic fit of focus groups within qualitative research approaches in the field of medical education. After defining, the nature of focus groups and when, and when not, to use them, the Guide takes on a more practical approach, taking the reader through the various steps that need to be taken in conducting effective focus group research. Finally, the Guide finishes with practical hints towards writing up a focus group study for publication.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                03 July 2018
                July 2018
                : 15
                : 7
                : 1402
                Affiliations
                [1 ]Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; anbuharvin94@ 123456gmail.com (H.A.M.B.); hatim@ 123456um.edu.my (A.H.S); jesjeet@ 123456um.edu.my (J.S.G.); ohkoh@ 123456um.edu.my (K.O.H.); chong_guan@ 123456um.edu.my (N.C.G.)
                [2 ]Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia; shadijah@ 123456iium.edu.my
                [3 ]Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; hasnizazh@ 123456um.edu.my
                Author notes
                [* ]Correspondence: syahrirz@ 123456siswa.um.edu.my ; Tel.: +6-03-7949-2763
                Author information
                https://orcid.org/0000-0003-1755-9188
                Article
                ijerph-15-01402
                10.3390/ijerph15071402
                6068982
                29970848
                b7d70c09-2e30-4bc0-ba39-e026003eaf4b
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 03 June 2018
                : 28 June 2018
                Categories
                Article

                Public health
                shared decision-making,antidepressants,depression,focus group discussion
                Public health
                shared decision-making, antidepressants, depression, focus group discussion

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