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JAPNA Article - Improving Patient-Centered Care for Veterans with Treatment-Resistant Depression Using Shared Decision-Making Tools - Jan-Feb 2023 (29:1)

Treatment resistant depression (TRD) is a common diagnosis affecting over 30% of military and veteran patients diagnosed with depression that is often severe, long-term, and expensive, and is frequently complicated by comorbidities which require additional interventions (Zisook et al., 2016).  TRD is linked to higher morbidity and mortality rates and also results in social, professional, and child-development concerns for patients (Rybeck et al., 2020). TRD is associated with both direct and indirect costs through decreased productivity and disability resulting in double the cost burden for this population as well as more expensive medical and psychiatric hospitalizations which averaged 6x more than non-TRD patients (Nemeroff, 2007). By identifying patients with TRD and including them in the decision-making process regarding treatment options, patients are more likely to adhere to the treatment course and report improved satisfaction with their provider interactions. Better patient adherence for medications, procedures, and appointment follow-up will lead to fewer hospitalizations and improved patient outcomes. With increased compliance and monitoring, overall costs are likely to decrease as less demand is placed on emergency department consults and crisis inpatient admissions. This will benefit veterans and providers through improved mutual trust and decreased disease/symptom burden. 

Authors: Cheyenne M. Allen, DNP, PMHNP-BC; Carla Bray, DNP, FNP-C

Disclosures: The authors and APNA planners have no relevant financial relationships to disclose. Off-label uses will not be discussed during this presentation.

Target Audience:  RN, APRN

Learning Outcomes:
Upon completion of this article, the participant will be able to:

1. Apply shared decision-making techniques to patient-centered care models.
   
2. Identify the necessary components of successful TRD treatment. 
   
3. Recognize the importance of TRD screening and patient-centered interventions.
   

Keywords: Depression, Treatment Resistant Depression, Veterans

Nursing Continuing Professional Development:
1.0 contact hours.  * In order to receive contact hours, you must: read the entire article, complete an evaluation, honor statement, and earn a passing score on the post test before the expiration date. You will have 5 tries to correctly answer the questions on the posttest and a score of 80% is required to pass. Once you have passed and completed the evaluation and honor statement, your nursing continuing professional development certificate will be generated online and available for immediate printing. Credit cannot be earned unless all components of the program are completed.  

The American Psychiatric Nurses Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

The contact hours for this session expire: February 28, 2025.

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