Table 2 Changes in the encounter decision aid based on participants’ feedback from the user testing to the final version
| Â | Continue | Adjust | Stop | |
|---|---|---|---|---|
Title | March 2016 | Use of antipsychotic medications after recovering from past episode of psychosis | ||
July 2016 | Antipsychotic medication: continue, adjust, or stop? for people who have stabilized | |||
Instructions | March 2016 | Use this Option Gridâ„¢ decision aid to help you and your clinician consider how best to manage your antipsychotic medications. | ||
| Â | July 2016 | Use this decision aid to help you, your caregiver, and your doctor (prescriber) decide how to best manage your medication. This decision aid is most appropriate for people who take medication for psychosis and for those who have had psychosis for the first time. | ||
Q1 | March 2016 | Making no changes to the medications you take. | Taking more or less medication, adding or changing if needed. It is best to take the fewest number of medicines at the lowest dose. This often needs adjustments and is best done with help from your clinician. | Gradually stopping your medications. This is best done with help from your clinician and may involve learning other strategies to manage your symptoms. |
July 2016 | Making no changes to your medications. Please ask your doctor about the effects of continuing to use antipsychotic medications. It is important to work closely with your doctor. | Taking more or less medication, adding or changing if needed. It is best to take the fewest number of medications at the lowest dose that works. Adjusting medication is best done with help from your doctor. | Slowly stopping your medications. This is best done with help from your doctor and may involve learning other ways to manage your symptoms. | |
Q2 | March 2016 | You can expect things to stay the same, both the good and the bad. | You can experience fewer medication related side effects, such as sleepiness, uncontrollable movements and weight gain. | You can avoid medication side effects such as sleepiness, uncontrollable movements and weight gain. |
July 2016 | You can expect things to stay the same. Medications can help you focus less on symptoms and more on the things that are important to you, like work or school. | You may have fewer medication side effects, such as sleepiness, uncontrollable movements and weight gain. | No revisions | |
Q3 | March 2016 | You might be on too high dose or too much medication. Common side effects are sleepiness, uncontrollable movements and weight gain. | Problems may come back on a lower dose, and you may have more difficulty working or concentrating. You may need more check ups to be sure that symptoms don’t come back. | Symptoms may get worse if medications are stopped. Roughly 80 in every 100 people (80%) will suffer symptoms again in one year after stopping medications. These symptoms may cause you to go back into the hospital. |
July 2016 | Common side effects are sleepiness, uncontrollable movements, weight gain, and other effects such as sexual problems. You might not be on the dose or combination of medications that’s best for you. | Symptoms may come back on a lower dose, and you may find it hard to work or concentrate. You may need more check-ups with your doctor to make sure that symptoms don’t come back. | Your symptoms may get worse if you stop taking medication. Roughly 80 in every 100 people (80%) will have symptoms again in the year after stopping medications. These symptoms may cause you to go back to a hospital or psychiatric community clinic. | |
Q4 | March 2016 | Try to find ways to limit side effects. You might want to eat health food, join patient groups and stay physically active. Avoid using alcohol or street drugs because they can make it hard to understand if your medications are working | Keep track of how you feel, using a journal so that you know if your medications are helping or not, and share it with your clinician. Maybe ask someone to give you feedback about how you are doing. Avoid using alcohol or street drugs because they can make it hard to understand if your medications are working. | Make sure that you have frequent contact with your clinician. Follow the schedule as you reduce the the medicine dose. Don’t downplay your symptoms if they come back. Avoid using alcohol or drugs because they can make it hard to understand if your medications are working. |
July 2016 | You can try to find ways to limit side effects, such as by eating healthy food, joining patient groups and staying physically active. Avoid alcohol and street drugs. | Keep track of how you feel and talk with your doctor. You can try support groups, mobile apps, or writing in a journal so that you know if your medications are helping or not. You can ask someone to give you feedback about how you are doing. Avoid alcohol and street drugs. | Talk regularly with your doctor, a mental health counselor, family members or a friend. Follow the schedule as you lower the medication dose. Don’tdownplay your symptoms if they come back. Avoid alcohol and street drugs. | |
Q5 | March 2016 | If the medications are being helpful, then you would get back to your usual activities. | Taking the lowest effective dose will cause fewer side effects. Being more alert and less bothered by side effects may help you get back to your normal activities. | It is likely that your symptoms will come back and make it more difficult to do your normal activities. Stay in close contact with your clinician. |
July 2016 | No revisions | Taking the lowest dose that works will cause fewer side effects. This may help you get back to your usual activities. | Once your symptoms improve, you will be able to go back to your usual activities. However, your symptoms will likely come back at some point. Stay in touch with your doctor. | |