The role of depression pharmacogenetic decision support tools in shared decision making

J Neural Transm (Vienna). 2017 Oct 29. doi: 10.1007/s00702-017-1806-8. [Epub ahead of print] URL: https://link.springer.com/article/10.1007%2Fs00702-017-1806-8

The role of depression pharmacogenetic decision support tools in shared decision making.

Arandjelovic K1, Eyre HA2,3,4,5, Lenze E6, Singh AB2, Berk M2,4,7, Bousman C4,8.

Abstract

Patients discontinue antidepressant medications due to lack of knowledge, unrealistic expectations, and/or unacceptable side effects. Shared decision making (SDM) invites patients to play an active role in their treatment and may indirectly improve outcomes through enhanced engagement in care, adherence to treatment, and positive expectancy of medication outcomes. We believe decisional aids, such as pharmacogenetic decision support tools (PDSTs), facilitate SDM in the clinical setting. PDSTs may likewise predict drug tolerance and efficacy, and therefore adherence and effectiveness on an individual-patient level. There are several important ethical considerations to be navigated when integrating PDSTs into clinical practice. The field requires greater empirical research to demonstrate clinical utility, and the mechanisms thereof, as well as exploration of the ethical use of these technologies.

KEYWORDS:

Adherence; Antidepressants; Decision support tool; Pharmacogenetics; Psychoeducation; Shared decision making; Therapeutic alliance

PMID: 29082439 DOI: 10.1007/s00702-017-1806-8