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

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.

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Acknowledgements

MB is currently supported by a NHMRC Senior Principal Research Fellowship 1059660.

Author information

Correspondence to Katarina Arandjelovic.

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Cite this article

Arandjelovic, K., Eyre, H.A., Lenze, E. et al. The role of depression pharmacogenetic decision support tools in shared decision making. J Neural Transm 126, 87–94 (2019). https://doi.org/10.1007/s00702-017-1806-8

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Keywords

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