Shared decision-making interventions for people with mental health conditions

Aoki, Yumi; Yaju, Yukari; Utsumi, Tomohiro; Storm, Marianne; Takaesu, Yoshikazu; Watanabe, Koichiro; Watanabe, Norio; Duncan, Edward; Edwards, Adrian

doi:10.1002/14651858.cd007297.pub3

Cited by 28 publications

(27 citation statements)

References 346 publications

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“…Patient participation has gained attention in the mental health field 15 similar to other somatic areas 16 . In addition, the majority of individuals with schizophrenia desire to participate in their own treatment decisions 31 .…”

Section: Discussionmentioning

confidence: 99%

“…A steering committee consisting of experts on schizophrenia treatment (all listed as authors) and DA methodology was gathered. The committee included 12 psychiatrists who regularly attend to individuals with schizophrenia and a psychiatric nurse with sufficient knowledge about SDM for those with mental health conditions 15,23 and experience developing DAs in psychiatry. [24][25][26] 2.4 | Literature review…”

Section: Steering Committeementioning

confidence: 99%

“…14 SDM has gained attention in psychiatric disorders and other physical disorders. 15 Decision aids (DAs) are decision-support tools that help stakeholders, including patients and health-care providers, participate in the SDM process. Thus, DAs help clarify health-care decisions that need to be considered, show relevant information and outcomes of related options, and explore patients' own preferences and values.…”

Section: Introductionmentioning

confidence: 99%

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Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia

Aoki

Takaesu

Matsui

et al. 2023

Neuropsychopharm Rep

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AimContinued antipsychotic treatment is the key to preventing relapse. Maintenance antipsychotic monotherapy and optimal dose use are recommended for individuals with stable schizophrenia because of their undesirable effects. Decision aids (DAs) are clinical conversation tools that facilitate shared decision‐making (SDM) between patients and health‐care providers. This study aimed to describe the development process and results of acceptability testing of a DA for individuals with stable schizophrenia, considering (i) whether to continue high‐dose antipsychotics or reduce to the standard dose and (ii) whether to continue two antipsychotics or shift to monotherapy.MethodsA DA was developed according to the guidelines for the appropriate use of psychotropic medications and International Patient Decision Aid Standards (IPDAS). First, a DA prototype was developed based on a previous systematic review and meta‐analysis conducted for identifying the effects of continuing or reducing antipsychotic treatment. Second, mixed‐method survey was performed among individuals with schizophrenia and health‐care providers to modify and finalize the DA.ResultsThe DA consisted of an explanation of schizophrenia, options to continue high‐dose antipsychotics or reduce to the standard dose, options to continue two antipsychotics or shift to monotherapy, pros and cons of each option, and a value‐clarification worksheet for each option. The patients (n = 20) reported acceptable language use (75%), adequate information (75%), and well‐balanced presentation (79%). Health‐care providers (n = 20) also provided favorable overall feedback. The final DA covered six IPDAS qualifying criteria.ConclusionA DA was successfully developed for schizophrenia, considering whether to reduce antipsychotics, which can be used in the SDM process.

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Section: Discussionmentioning

confidence: 99%

Section: Steering Committeementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia

Aoki

Takaesu

Matsui

et al. 2023

Neuropsychopharm Rep

Self Cite

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“…As person‐centred care has attracted attention, providing satisfactory care that respects older adults' demands to make decisions has become essential. Several studies have suggested that patients and people with dementia who participate in decision‐making can experience higher satisfaction with their care 2,3 …”

Section: Introductionmentioning

confidence: 99%

“…Several studies have suggested that patients and people with dementia who participate in decision-making can experience higher satisfaction with their care. 2,3 Recently, an integrative framework was proposed that involves a multistep process in which individuals make decisions; this framework specifies the mechanisms behind the effects of ageing and potential moderators in the decision-making process. 4 According to this model, age-related cognitive decline limits predecisional processes (e.g., searching for relevant information).…”

Section: Introductionmentioning

confidence: 99%

Decision‐making involvement and onset of cognitive impairment in community‐dwelling older care recipients: a 2‐year longitudinal study

Komatsu,

Nakagawa,

Noguchi

et al. 2023

Psychogeriatrics

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BackgroundThe decision‐making of older adults and people with dementia is attracting more attention among healthcare professionals. While cognitive impairment has been examined as a factor related to decision‐making, it can also be assumed that involvement in decision‐making leads to the maintenance of cognitive function. This study examined the association of the decision‐making process with the onset of cognitive impairment.MethodsWe analyzed data from a 2‐year longitudinal panel survey of community‐dwelling care recipients aged ≥65 years in Japan. The sample included 406 participants who responded to both baseline and follow‐up surveys, were cognitively intact at baseline, and had no missing cognitive impairment data regarding onset at follow‐up. The status of decision‐making involvement was assessed using a single item and classified into four categories: ‘very involved,’ ‘less involved,’ ‘unclear about desired care,’ and ‘having no one to share the decision.’ResultsAmong the participants (women, 65.0%; ≥75 years old: 68.2%), the incidence of cognitive impairment during the follow‐up was 26.6%. Multivariable logistic regression showed that, compared with highly involved participants, those who lacked clarity about desired care were more likely to develop an onset of cognitive impairment (odds ratio: 5.49; 95% confidence interval: 1.63–18.54; P = 0.006).ConclusionEven among cognitively intact care recipients, those who are not able to formulate their desired care may be at risk of cognitive decline. Therefore, support for the decision‐making process, not limited to the final decision, is essential to improving the prognosis of community‐dwelling care recipients.

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What are the effects of shared decision-making interventions for people with mental health conditions?

Davies

2024

Cochrane Clinical Answers

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Shared decision-making interventions for people with mental health conditions

Cited by 28 publications

References 346 publications

Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia

Development and acceptability testing of a decision aid for considering whether to reduce antipsychotics in individuals with stable schizophrenia

Decision‐making involvement and onset of cognitive impairment in community‐dwelling older care recipients: a 2‐year longitudinal study

What are the effects of shared decision-making interventions for people with mental health conditions?

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