A Web-Based Program to Empower Patients Who Have Schizophrenia to Discuss Quality of Care With Mental Health Providers

Steinwachs, Donald M.; Roter, Debra; Skinner, Elizabeth A.; Lehman, Anthony F.; Fahey, Michael; Cullen, Bernadette; Everett, Anita; Gallucci, Gerard

doi:10.1176/appi.ps.62.11.1296

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…However, they contradict the findings by Hamann et al [3] and Steinwachs et al [13] who found a positive effect of decision aids on patients’ involvement in consultations with their clinicians. This discrepancy can be explained by several reasons.…”

Section: Discussioncontrasting

confidence: 78%

“…In our study, patients could use the decision aid either in the clinic or at home, with or without assistance, whereas in the trial by Hamann et al [3], patients used the decision aid in a psychiatric ward with assistance of trained nurses. The setting in the study by Steinwachs et al [13] was not described. Third, our response rate was very low.…”

Section: Discussionmentioning

confidence: 99%

“…Patients used the program on computers at the clinic where experiential experts were available for assistance. Two small-scale randomized clinical trials were conducted [12,13]. The first trial showed that patients were able to electronically design their own care plan, but there was no difference between intervention and control groups in satisfaction with the care planning process, which was the primary outcome [12].…”

Section: Introductionmentioning

confidence: 99%

“…The first trial showed that patients were able to electronically design their own care plan, but there was no difference between intervention and control groups in satisfaction with the care planning process, which was the primary outcome [12]. The second trial reported that a Web-based support system encouraging patients to discuss their current status and treatment with their clinician resulted in patients being more verbally active during health visits [13]. …”

Section: Introductionmentioning

confidence: 99%

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A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

Krieke¹,

Emerencia²,

Boonstra³

et al. 2013

J Med Internet Res

114

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BackgroundMental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes.ObjectiveThis study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders.MethodsThe study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation.ResultsIn all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical decision making (COMRADE satisfaction with communication: F1,68=0.422, P=.52; COMRADE confidence in decision: F1,67=0.086, P=.77). In addition, results of the process evaluation suggest that the intervention did not optimally fit in with routine practice of the participating teams.ConclusionsThe development of electronic decision aids to facilitate shared medical decision making is encouraged and many people with a psychotic disorder can work with them. This holds for both first-episode patients and long-term care patients, although the latter group might need more assistance. However, results of this paper could not support the assumption that the use of electronic decision aids increases patient involvement in medical decision making. This may be because of weak implementation of the study protocol and a low response rate.Trial RegistrationDutch Trial Register (NTR) trial number: 10340; http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=10340 (Archived by WebCite at http://www.webcitation.org/6Jj5umAeS).

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

Krieke¹,

Emerencia²,

Boonstra³

et al. 2013

J Med Internet Res

114

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“…Computerized interventions for schizophrenia have already made good use of videos to relay psychoeducational information or depict training roleplays in supervised clinic settings (Gottlieb et al, 2013; Steinwachs et al, 2011). The study adds to these findings and suggests that video interventions may be a feasible, usable, acceptable, and highly engaging method for more flexible delivery of interventions to people with schizophrenia using mobile technology outside of the controlled clinic environment.…”

Section: Discussionmentioning

confidence: 99%

Video-based mobile health interventions for people with schizophrenia: Bringing the “pocket therapist” to life.

Ben‐Zeev

Brian

Aschbrenner

et al. 2018

Psychiatric Rehabilitation Journal

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Objective To examine whether video-based mHealth interventions are feasible, acceptable, understandable, and engaging to people with schizophrenia. Methods This study used a mixed methods design. Ten individuals with schizophrenia spectrum disorders were recruited for a month-long trial in which they used FOCUS-AV, a smartphone system that offers video and written intervention options. Participants completed post-trial measures and engaged in semi-structured interviews. Findings One participant dropped out. The remaining nine participants used intervention videos successfully. Participants responded to 67% of system-delivered prompts to engage FOCUS-AV, and 52% of FOCUS-AV use was initiated by the users. On average, participants used interventions six days a week, four times daily. Participants used video functions an average of 28 times. They chose video over written interventions on 67% of the times they used on-demand functions, but opted for written content 78% of the times they responded to pre-scheduled prompts. Clinician videos were rated as more personal, engaging, and helpful than written interventions. Video and written interventions were rated equally usable and understandable. Written interventions were rated as more favorable in letting users proceed at their own pace. Similarly to what is seen in live therapy, the communication style and demeanor of clinicians depicted in intervention videos reportedly affected participants' experience with treatment. Conclusions and Implications for Practice Video-based mHealth may be a feasible, usable, acceptable, and highly engaging method for flexible delivery of interventions to people with schizophrenia using mobile technology. Producing intervention videos is more time, labor, and cost intensive than generating written content, but participant feedback suggests there may be added value in this approach. Additional research will determine whether video-based mHealth interventions lead to better, faster, or more sustainable clinical gains.

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Technology to Promote and Increase Physical Activity in Heart Failure

Franklin

2015

Heart Failure Clinics

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A Web-Based Program to Empower Patients Who Have Schizophrenia to Discuss Quality of Care With Mental Health Providers

Cited by 14 publications

References 15 publications

A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

Video-based mobile health interventions for people with schizophrenia: Bringing the “pocket therapist” to life.

Technology to Promote and Increase Physical Activity in Heart Failure

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