Johannes Hamann1, Anna Parchmann2, Nina Sassenberg2, Katharina Bronner2, Margot Albus3, Alwin Richter4, Sandra Hoppstock5, Werner Kissling2. 1. Psychiatric Department, Technische Universität München, Munich, Germany. j.hamann@lrz.tum.de. 2. Psychiatric Department, Technische Universität München, Munich, Germany. 3. Isar Amper Klinikum München Ost, Haar, Germany. 4. Bezirkskrankenhaus Mainkofen, Deggendorf, Germany. 5. Bezirkskrankenhaus Kaufbeuren, Kaufbeuren, Germany.
Abstract
PURPOSE: Many patients with schizophrenia have a desire for shared decision-making (SDM). However, in clinical practice SDM often does not take place. One cause might be that many patients behave passively in the medical encounter, therefore not facilitating SDM. It was the aim of the study to evaluate the effects of a patient directed SDM-training on patients' communicative behavior in the consultation, their attitudes towards decision-making and their long-term adherence. METHODS: Randomized-controlled trial comparing a five-session SDM-training for inpatients with schizophrenia with five sessions of non-specific group training. The SDM-training sessions included motivational (e.g. prospects of participation, patient rights) and behavioral aspects (e.g. role plays) and addressed important aspects of the patient-doctor interaction such as question asking or giving feedback. RESULTS: N = 264 patients were recruited in four psychiatric hospitals in Germany. The SDM-training yielded no group differences regarding the main outcome measure (treatment adherence) at 6 and 12 months after discharge. However, there were short-term effects on patients' participation preferences, their wish to take over more responsibility for medical decisions and (according to their psychiatrists' estimate) their behavior in psychiatric consultations. CONCLUSIONS: While there was no effect regarding treatment adherence, the shared decision-making training for inpatients with schizophrenia has been shown to increase patients' active behavior in psychiatric consultations during their inpatient treatment. When implemented it should be combined with complementary SDM interventions (decision support tools and communication training for professionals) to yield maximum effects.
RCT Entities:
PURPOSE: Many patients with schizophrenia have a desire for shared decision-making (SDM). However, in clinical practice SDM often does not take place. One cause might be that many patients behave passively in the medical encounter, therefore not facilitating SDM. It was the aim of the study to evaluate the effects of a patient directed SDM-training on patients' communicative behavior in the consultation, their attitudes towards decision-making and their long-term adherence. METHODS: Randomized-controlled trial comparing a five-session SDM-training for inpatients with schizophrenia with five sessions of non-specific group training. The SDM-training sessions included motivational (e.g. prospects of participation, patient rights) and behavioral aspects (e.g. role plays) and addressed important aspects of the patient-doctor interaction such as question asking or giving feedback. RESULTS: N = 264 patients were recruited in four psychiatric hospitals in Germany. The SDM-training yielded no group differences regarding the main outcome measure (treatment adherence) at 6 and 12 months after discharge. However, there were short-term effects on patients' participation preferences, their wish to take over more responsibility for medical decisions and (according to their psychiatrists' estimate) their behavior in psychiatric consultations. CONCLUSIONS: While there was no effect regarding treatment adherence, the shared decision-making training for inpatients with schizophrenia has been shown to increase patients' active behavior in psychiatric consultations during their inpatient treatment. When implemented it should be combined with complementary SDM interventions (decision support tools and communication training for professionals) to yield maximum effects.
Authors: Bradley D Stein; Jane N Kogan; Mark J Mihalyo; James Schuster; Patricia E Deegan; Mark J Sorbero; Robert E Drake Journal: Community Ment Health J Date: 2012-07-27
Authors: Margarita Alegría; Nicholas Carson; Michael Flores; Xinliang Li; Ping Shi; Anna Sophia Lessios; Antonio Polo; Michele Allen; Mary Fierro; Alejandro Interian; Aida Jimenez; Martin La Roche; Catherine Lee; Roberto Lewis-Fernández; Gabriela Livas-Stein; Laura Safar; Catherine Schuman; Joan Storey; Patrick E Shrout Journal: JAMA Psychiatry Date: 2014-05 Impact factor: 21.596
Authors: Stefan Leucht; Johannes Hamann; Spyridon Siafis; Nicola Bursch; Katharina Müller; Lisa Schmid; Florian Schuster; Jakob Waibel; Tri Huynh; Florian Matthes; Alessandro Rodolico; Peter Brieger; Markus Bühner; Stephan Heres Journal: BMC Psychiatry Date: 2022-06-17 Impact factor: 4.144
Authors: France Légaré; Rhéda Adekpedjou; Dawn Stacey; Stéphane Turcotte; Jennifer Kryworuchko; Ian D Graham; Anne Lyddiatt; Mary C Politi; Richard Thomson; Glyn Elwyn; Norbert Donner-Banzhoff Journal: Cochrane Database Syst Rev Date: 2018-07-19
Authors: Margot Metz; Iman Elfeddali; Marjolein Veerbeek; Edwin de Beurs; Aartjan Beekman; Christina van der Feltz-Cornelis Journal: PLoS One Date: 2018-06-26 Impact factor: 3.240
Authors: J Hamann; F Holzhüter; S Blakaj; S Becher; B Haller; M Landgrebe; M Schmauß; S Heres Journal: Epidemiol Psychiatr Sci Date: 2020-06-16 Impact factor: 6.892