The effects of a shared decision-making intervention in primary care of depression: A cluster-randomized controlled trial

Loh, Andreas; Simón, Daniela; Wills, Celia E.; Kriston, Levente; Niebling, Wilhelm; Härter, Martin

doi:10.1016/j.pec.2007.03.023

Cited by 337 publications

(362 citation statements)

References 39 publications

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“…It can positively impact on patient experience, satisfaction and participation in care and was better than usual care in treating 405 patients newly diagnosed with depression [8]. However, this effect is not universal.…”

Section: Introductionmentioning

confidence: 99%

Shared decision-making in back pain consultations: an illusion or reality?

Jones

Roberts

Little³

et al. 2014

Eur Spine J

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Purpose Amid a political agenda for patient-centred healthcare, shared decision-making is reported to substantially improve patient experience, adherence to treatment and health outcomes. However, observational studies have shown that shared decision-making is rarely implemented in practice. The purpose of this study was to measure the prevalence of shared decision-making in clinical encounters involving physiotherapists and patients with back pain.Method Eighty outpatient encounters (comprising 40 h of data) were observed audio-recorded, transcribed verbatim and analysed using the 12-item OPTION scale. The higher the score, the greater is the shared decision-making competency of the clinicians. Results The mean OPTION score was 24.0 % (range 10.4-43.8 %). Conclusion Shared decision-making was under-developed in the observed back pain consultations. Clinicians' strong desire to treat acted as a barrier to shared decisionmaking and further work should focus on when and how it can be implemented.

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Section: Introductionmentioning

confidence: 99%

Shared decision-making in back pain consultations: an illusion or reality?

Jones

Roberts

Little³

et al. 2014

Eur Spine J

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“…Preferences are varied, for example younger people are more likely to prefer active CDM (6). Existing research has focussed on decisions made with medical doctors (7,8) even though patients make decisions with clinicians from across the multi-disciplinary team.…”

Section: Introductionmentioning

confidence: 99%

Empowerment and satisfaction in a multinational study of routine clinical practice

Clarke

Puschner

Jordan

et al. 2014

Acta Psychiatr Scand

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Mike (2015) Empowerment and satisfaction in a multinational study of routine clinical practice. Acta Psychiatrica Scandinavica, 131 (5). pp. 369-378. ISSN 1600-0447Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/34260/1/AFD%20APS%20CEDAR%20Empowerment %20and%20satisfaction.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. We tested whether mental health patients are more satisfied with a decision made (a) using their preferred decision-making style and (b) with a clinician with the same decision-making style preference. MethodAs part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. ResultsPatients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, p=0.005, 95%CI 1.32 to 4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, p=0.003, 95%CI 1.48 to 6.82). ConclusionMore active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction. KeywordsDecision Making, Mental Health 3. The extent to which the decision topic impacted on preference and agreement is unknown.4

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“…Clever et al 13 have demonstrated that both guideline-concordant care and remission rates are strongly associated with patient ratings of involvement in medical decision making. A randomized trial by Loh et al 14 demonstrated that an intervention in German primary care with SDM training for physicians in and provision of a patient-centered decision aid led to greater doctor facilitation of patient participation, greater patient-rated involvement in care, and greater patient adherence. However, the only study of the frequency of SDM in usual care of depression is that of Young et al, 15 who analyzed audiotapes of single interactions between physicians and standardized patients.…”

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confidence: 99%

How Much Shared Decision Making Occurs in Usual Primary Care of Depression?

Solberg

Crain

Rubenstein

et al. 2014

The Journal of the American Board of Family Medicine

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Background: Shared decision making (SDM) is an important component of patient-centered care, but there is little information about its use in the primary care of depression, so we sought to study its frequency in usual care as reported by patients.Methods: Telephone interview of 1168 depressed patients taking antidepressants in 88 Minnesota primary care clinics who were identified from pharmacy claims data soon after a prescription for an antidepressant. We measured depression severity with the 9-item Patient Health Questionnaire and used a composite measure of SDM that reflected patient involvement in treatment decisions.Results: These patients reported an average score for SDM of 50.7 (standard deviation, 32.8) on a scale of 0 to 100, where higher scores equate with greater SDM. In univariate analyses, the largest differences among scores were for age (scores of 58, 53, 45, and 33 for those aged 18 -34, 35-49, 50 -64, and >64 years, respectively; P < .0001); duration of treatment (a score of 56.6 on treatment <6 weeks vs 45.5 if longer; P < .001); and other treatments in the past 6 months (60.5 if yes vs. 46.0 if no; P ‫؍‬ .001). SDM was not associated with any clinic characteristics, but it was correlated with patientreported quality of care (r ‫؍‬ 0.48; P < .001). Multivariate analyses confirmed some of these findings while showing a more complex set of relationships.Conclusions: Older patients with depression and those who have been in treatment longer report much less SDM in their care. Improving SDM, especially for these groups, may be an important target for improving patient experience and perceived quality.

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The effects of a shared decision-making intervention in primary care of depression: A cluster-randomized controlled trial

Cited by 337 publications

References 39 publications

Shared decision-making in back pain consultations: an illusion or reality?

Shared decision-making in back pain consultations: an illusion or reality?

Empowerment and satisfaction in a multinational study of routine clinical practice

How Much Shared Decision Making Occurs in Usual Primary Care of Depression?

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