CHOICE‑D: Empowering Patients with a Plain-Language Guide to Depression Treatment
Improving mental health care requires collaboration between clinicians, patients, and families. The CHOICE‑D (CANMAT Health Options for Integrated Care and Empowerment in Depression) Guide represents a novel approach to translating clinical depression treatment guidelines into a plain-language resource designed for patients and families. Developed through a collaborative co-design process with individuals with lived experience of depression, the guide aims to foster informed discussions with healthcare providers and enhance patient autonomy in treatment decisions.
What is the CHOICE‑D Guide?
The CHOICE‑D Guide is a patient- and family-oriented adaptation of the 2016 CANMAT clinical guidelines for major depressive disorder (MDD). While traditional guidelines are intended for clinicians and often contain complex medical terminology, the CHOICE‑D Guide presents evidence-based information in clear, accessible language. The guide includes key topics such as depressive symptoms, treatment options, safety and side effects, and common misconceptions, while providing practical tools to support patient engagement and shared decision-making.
“Effective treatment of major depressive disorder (MDD) ideally involves the collaboration of patients and practitioners in patient-centred care, using best practice as identified by evidence‐based treatment guidelines.”
How Was the Guide Developed?
The CHOICE‑D Guide was created using a structured co-design approach. A writing committee of individuals with lived experience of depression was recruited through a national call, with eight members ultimately participating. Members received training in guideline content, plain-language translation, and graphic design, and were guided through structured exercises including content prioritization, translation practice, and group discussion. Expert consultations in psychiatry, patient advocacy, and knowledge translation informed the overall project design.
Key Features and Tools
The guide was structured to support patient autonomy and engagement:
- Content Prioritization: Sections on psychotherapy, pharmacotherapy, and first-line treatments were highlighted, emphasizing effectiveness, safety, and misconceptions.
- Practical Tools: Question scripts, self-triaging resources, and decision-making aids were included to empower patients during clinical consultations.
- User-Friendly Design: Clear and hopeful language, concise text, white space, graphics, and a glossary of key terms improve readability.
- Additional Perspectives: Resource sections provide insights drawn from the lived experiences of the writing committee.
Applications in Mental Health Care
By translating clinician-oriented guidelines into a patient-centred resource, the CHOICE‑D Guide supports shared decision-making, improves mental health literacy, and encourages active involvement in treatment. It is designed for distribution in diverse settings including clinics, community centres, and educational institutions, and can be adapted for culturally diverse audiences.
“The creation of patient‐developed depression guidelines is a novel initiative with ground‐breaking clinical implications for patients (and families), which include improved understanding of treatment options, greater involvement in health care decision making, and increased satisfaction in primary and secondary health care.”
Advantages of the CHOICE‑D Guide
- Patient-Centred: Developed by individuals with lived experience, reflecting real-world challenges and needs.
- Accessible: Plain language and visual aids reduce barriers to understanding complex clinical information.
- Engagement-Oriented: Practical tools encourage active participation in healthcare decision-making.
- Flexible Dissemination: Can be used across multiple settings and adapted for different populations.
Final Takeaway
The CHOICE‑D Guide demonstrates how clinical guidelines can be transformed into practical, patient-centred resources through the active involvement of those with lived experience. By improving health literacy, fostering shared decision-making, and promoting patient autonomy, the guide has the potential to enhance the quality of depression care and support meaningful engagement between patients, families, and clinicians.
Citation: Fonseka, T. M., Pong, J. T., Kcomt, A., Kennedy, S. H., & Parikh, S. V. (2020). Collaborating with individuals with lived experience to adapt CANMAT clinical depression guidelines into a patient treatment guide: The CHOICE‐D co‐design process. Journal of Evaluation in Clinical Practice, 26(4), 1259–1269. https://doi.org/10.1111/jep.13308.