title: The assessment of depressive patients' involvement in decision making in audio-taped primary care consultations.
abstract: OBJECTIVE
  In primary care of depression treatment options such as antidepressants, counseling and psychotherapy are reasonable. Patient involvement could foster adherence and clinical outcome. However, there is a lack of empirical information about the extent to which general practitioners involve patients in decision making processes in this condition, and about the consultation time spent for distinct decision making tasks.
  
  
  METHODS
  Twenty general practice consultations with depressive patients prior to a treatment decision were audio-taped and transcribed. Patient involvement in decision making was assessed with the OPTION-scale and durations of decision making stages were measured.
  
  
  RESULTS
  Mean duration of consultations was 16 min, 6s. The mean of the OPTION-items were between 0.0 and 26.9, in a scale range from 0 to 100. Overall, 78.6% of the consultation time was spent for the step "problem definition" (12 min, 42 s).
  
  
  CONCLUSIONS
  Very low levels of patient involvement in medical decisions were observed in consultations about depression. Physicians used the majority of their time for the definition of the patient's medical problem.
  
  
  CONCLUSIONS
  To improve treatment decision making in this condition, general practitioners should enhance their decision making competences and be more aware of the time spent in each decision making stage.
authors.affiliation: University Hospital of Freiburg, Department of Psychiatry and Psychotherapy, Section Clinical Epidemiology and Health Services Research, Germany. Andreas.Loh@uniklinik-freiburg.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Loh
authors.forename: Daniela
authors.initials: D
authors.lastname: Simon
authors.forename: Katrin
authors.initials: K
authors.lastname: Hennig
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hennig
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
mesh_terms: D003657:Decision Making; D003866:Depressive Disorder / Q000628:therapy*; D005194:Family Practice; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D013637:Tape Recording; D013997:Time Factors