Shared decision-making in mental health care using routine outcome monitoring: results of a cluster randomised-controlled trial

Social Psychiatry and Psychiatric Epidemiology
M J MetzA T F Beekman

Abstract

To investigate the effects of Shared Decision-Making (SDM) using Routine Outcome Monitoring (ROM) primary on patients' perception of Decisional Conflict (DC), which measures patients' engagement in and satisfaction with clinical decisions, and secondary on working alliance and treatment outcomes. Multi-centre two-arm matched-paired cluster randomised-controlled trial in Dutch specialist mental health care. SDM using ROM (SDMR) was compared with Decision-Making As Usual (DMAU). Outcomes were measured at baseline (T0) and 6 months (T1). Multilevel regression and intention-to-treat analyses were used. Post hoc analyses were performed on influence of subgroups and application of SDMR on DC. Seven teams were randomised to each arm. T0 was completed by 186 patients (51% intervention; 49% control) and T1 by 158 patients (51% intervention, 49% control). DC, working alliance, and treatment outcomes reported by patients did not differ significantly between two arms. Post hoc analyses revealed that SDMR led to less DC among depressed patients (p = 0.047, d =- 0.69). If SDMR was applied well, patients reported less DC (SDM: p = 0.000, d = - 0.45; ROM: p = 0.021, d = - 0.32), which was associated with better treatment outcomes. Except for p...Continue Reading

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Dec 7, 2017·Social Psychiatry and Psychiatric Epidemiology·Margot J MetzAartjan T F Beekman

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Citations

Nov 16, 2019·Social Psychiatry and Psychiatric Epidemiology·Inés Morán-SánchezMaria D Pérez-Cárceles
Sep 17, 2020·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Jens C ThimmWenche Malmedal
Aug 10, 2019·Journal of Evaluation in Clinical Practice·Wilson T TrustyJoshua K Swift
Aug 8, 2020·Japan Journal of Nursing Science : JJNS·Yumi Aoki
Dec 4, 2020·Patient Education and Counseling·Inés Morán-SánchezMaría D Pérez-Cárceles
Aug 10, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Elizabeth C ThomasYaara Zisman-Ilani
Aug 11, 2021·Patient Education and Counseling·Vininder KhunkhunMichael S Scheeringa
Nov 9, 2021·The Cochrane Database of Systematic Reviews·Janet JullDawn Stacey

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