Abstract
Women face complicated decisions regarding psychotropic medication use during pregnancy. Patient decision aids (PDAs) could be a valuable tool to assist with decision-making. The objective of this review was to evaluate the effectiveness of PDAs in this population. A systematic search of the literature was conducted using PRISMA guidelines. Three major databases were searched to identify articles published between 2006 and June 2020. Studies were included if they evaluated use of a PDA for women considering medication for mental illness during pregnancy. A total of 4629 titles were returned from the search; however, only three studies met inclusion criteria and were selected for analysis. Two were pilot randomised controlled trials in women considering antidepressant use during pregnancy, and one was a non-randomised study in women considering medication for the treatment of opioid use disorder (OUD). The PDAs had good acceptability across all three studies. The randomised trials assessed knowledge, decisional conflict, depression, and anxiety, with non-significant trends towards reduced decisional conflict and anxiety in the PDA groups. PDAs have the potential to assist women with mental illnesses to make decisions regarding medication use during pregnancy; however, current evidence is too limited to evaluate the effectiveness of PDAs for this population.
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MeSH terms (and their appropriate keywords) included the following terms employing the Boolean logic algorithm and explode function: (decision making OR decision making, computer assisted OR decision aid OR patient participation OR decision support systems, clinical) AND (pregnancy OR pregnant women OR perinatal care OR prenatal care) AND (mental health OR mental disorders OR mood disorders OR depressive disorders OR anxiety disorders OR bipolar disorders OR psychotic disorders OR schizophrenia OR substance-related disorders OR psychotropic drugs OR antidepressive agents OR anti-anxiety agents OR antimanic agents OR antipsychotic agents OR “hypnotics and sedatives”).
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Broughton, L.C., Medlicott, N.J. & Smith, A.J. Effectiveness of patient decision aids in women considering psychotropic medication use during pregnancy: a literature review. Arch Womens Ment Health 24, 569–578 (2021). https://doi.org/10.1007/s00737-021-01118-3
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DOI: https://doi.org/10.1007/s00737-021-01118-3