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Tai AMY, Kim JJ, Schmeckenbecher J, Kitchin V, Wang J, Kazemi A, Masoudi R, Fadakar H, Iorfino F, Krausz RM. Clinical decision support systems in addiction and concurrent disorders: A systematic review and meta-analysis. J Eval Clin Pract 2024. [PMID: 38979849 DOI: 10.1111/jep.14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION This review aims to synthesise the literature on the efficacy, evolution, and challenges of implementing Clincian Decision Support Systems (CDSS) in the realm of mental health, addiction, and concurrent disorders. METHODS Following PRISMA guidelines, a systematic review and meta-analysis were performed. Searches conducted in databases such as MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science through 25 May 2023, yielded 27,344 records. After necessary exclusions, 69 records were allocated for detailed synthesis. In the examination of patient outcomes with a focus on metrics such as therapeutic efficacy, patient satisfaction, and treatment acceptance, meta-analytic techniques were employed to synthesise data from randomised controlled trials. RESULTS A total of 69 studies were included, revealing a shift from knowledge-based models pre-2017 to a rise in data-driven models post-2017. The majority of models were found to be in Stage 2 or 4 of maturity. The meta-analysis showed an effect size of -0.11 for addiction-related outcomes and a stronger effect size of -0.50 for patient satisfaction and acceptance of CDSS. DISCUSSION The results indicate a shift from knowledge-based to data-driven CDSS approaches, aligned with advances in machine learning and big data. Although the immediate impact on addiction outcomes is modest, higher patient satisfaction suggests promise for wider CDSS use. Identified challenges include alert fatigue and opaque AI models. CONCLUSION CDSS shows promise in mental health and addiction treatment but requires a nuanced approach for effective and ethical implementation. The results emphasise the need for continued research to ensure optimised and equitable use in healthcare settings.
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Affiliation(s)
- Andy Man Yeung Tai
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jane J Kim
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jim Schmeckenbecher
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Vanessa Kitchin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Johnston Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alireza Kazemi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raha Masoudi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hasti Fadakar
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Reinhard Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Sedlakova J, Westermair AL, Biller-Andorno N, Meier CA, Trachsel M. Comparison of analog and digital patient decision aids for the treatment of depression: a scoping review. Front Digit Health 2023; 5:1208889. [PMID: 37744684 PMCID: PMC10513051 DOI: 10.3389/fdgth.2023.1208889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Patient decision aids (PDAs) are important tools to empower patients and integrate their preferences and values in the decision-making process. Even though patients with mental health problems have a strong interest in being more involved in decision making about their treatment, research has mainly focused on PDAs for somatic conditions. In this scoping review, we focus on patients suffering from depression and the role of PDAs for this patient group. The review offers an overview of digital and analog PDAs, their advantages and disadvantages as well as recommendations for further research and development. Methods A systematic search of the existing literature guided by the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - extension for scoping reviews (PRISMA-ScR) was conducted. Three electronic literature databases with the appropriate thematic focus were searched (PubMed, PsycInfo, and Web of Science). The search strategy used controlled and natural language to search for the key concepts decision aids and depression. The articles were selected in a two-step process guided by predefined inclusion and exclusion criteria. We narratively synthetized information extracted from 40 research articles. Results We included 40 articles in our review. Our review revealed that there is more focus on digital PDAs in research than in clinical practice. Digitalization can enhance the benefits of PDAs by developing tools that are more efficient, interactive, and personalized. The main disadvantages of both types of PDAs for the treatment of depression are related to time, dissemination, and capacity building for the health care providers. Digital PDAs need to be regularly updated, effective strategies for their dissemination and acceptance need to be identified, and clinicians need sufficient training on how to use digital PDAs. There is more research needed to study which forms of PDAs are most appropriate for various patient groups (e.g., older adults, or patients with comorbidities), and to identify the most effective ways of PDAs' integration in the clinical workflow. The findings from our review could be well aligned with the International Patient Decision Aids Standards. Discussion More research is needed regarding effective strategies for the implementation of digital PDAs into the clinical workflow, ethical issues raised by the digital format, and opportunities of tailoring PDAs for diverse patient groups.
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Affiliation(s)
- Jana Sedlakova
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
| | - Anna Lisa Westermair
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
- Clinical Ethics Unit, University Hospital of Basel (USB), Basel, Switzerland
- Clinical Ethics Unit, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich (UZH), Zürich, Switzerland
| | - Christoph A. Meier
- Department of Internal Medicine, University Hospital Zurich (USZ), Zürich, Switzerland
- Medical Faculty, University of Geneva, Geneva, Switzerland
| | - Manuel Trachsel
- Clinical Ethics Unit, University Hospital of Basel (USB), Basel, Switzerland
- Clinical Ethics Unit, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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Hart MJ, Sung JY, McQuillin SD, Schleider JL. Expanding the reach of psychosocial services for youth: Untapped potential of mentor-delivered single session interventions. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1255-1272. [PMID: 36017616 DOI: 10.1002/jcop.22927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/30/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
At present, the mental healthcare system cannot meet the demand for services, and the need-to-access gap is widest among children and adolescents. Single session interventions (SSIs) are brief, intentional, and mechanism-targeted programs that have shown promise in increasing the reach of effective, evidence-based services; yet, a wide gap still remains due to structural barriers (e.g., lack of awareness, workforce shortages). The present paper posits the integration of SSIs and mentor-delivered programs as a promising future step to further overcome the inaccessibility of youth mental health services. Capitalizing on the advantages of mentoring relationships (e.g., the associated interpersonal benefits and mentors' pre-existence in most community settings) has the potential to complement and enhance the value of SSIs, and to expand the acceptability and reach of evidence-based mental health services. In this paper, we discuss the anticipated benefits of mentor-delivered SSIs, as well as cautionary considerations related to the proposed model. To conclude, we highlight the necessary implementation and research implications.
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Affiliation(s)
- Mackenzie J Hart
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Jenna Y Sung
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Samuel D McQuillin
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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Thomas EC, Suarez J, Lucksted A, Siminoff L, Hurford I, Dixon L, O'Connell M, Salzer M. Treatment decision-making needs among emerging adults with early psychosis. Early Interv Psychiatry 2022; 16:78-90. [PMID: 33599089 PMCID: PMC9116145 DOI: 10.1111/eip.13134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/14/2021] [Accepted: 02/02/2021] [Indexed: 02/06/2023]
Abstract
AIM Many emerging adults disengage from early intervention in psychosis (EIP) services prematurely. Service disengagement may be in part due to having unresolved treatment decision-making needs about use of mental health services. A basic understanding of the decision-making needs of this population is lacking. The purpose of this qualitative study was to identify the range of treatment decisions that emerging adults face during their initial engagement in an EIP program and elucidate barriers and facilitators to decision-making. METHODS Twenty emerging adults with early psychosis were administered semistructured interviews to capture treatment decision-making experiences during the first six months after enrolment in an EIP program. Interviews were audio-recorded and transcribed verbatim. Responses were independently coded by two authors using an integrated thematic analysis approach; differences in coding were discussed to consensus. Data analysis was facilitated using NVivo 12 Plus. RESULTS Emerging adults identified numerous decisions faced after EIP enrolment. Decisions pertaining to life and treatment goals and to starting and continuing psychiatric medication were commonly selected as the most difficult/complicated. Decision-making barriers included not having the right amount or type of information/knowledge, social factors (e.g., lacking social support, opposition/pressure), lacking internal resources (e.g., cognitive and communication skills, self-efficacy, motivation) and unappealing options. Obtaining information/knowledge, social supports (e.g., connection/trust, learning from others' experiences, encouragement), considering personal values, and time were decision-making facilitators. CONCLUSIONS This study informs development and optimization of interventions to support decision-making among emerging adults with early psychosis, which may promote service engagement.
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Affiliation(s)
- Elizabeth C Thomas
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - John Suarez
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Alicia Lucksted
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Laura Siminoff
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Irene Hurford
- Irene Hurford MD PLLC, Jenkintown, Pennsylvania, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Maria O'Connell
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Mark Salzer
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Thomas EC, Suarez J, Lucksted A, Siminoff LA, Hurford I, Dixon LB, O'Connell M, Penn DL, Salzer MS. Facilitating treatment engagement for early psychosis through peer-delivered decision support: intervention development and protocol for pilot evaluation. Pilot Feasibility Stud 2021; 7:189. [PMID: 34689830 PMCID: PMC8543800 DOI: 10.1186/s40814-021-00927-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 10/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact. METHODS The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engagement in the program) will also be assessed. Additionally, through observation and feedback from the peer decision coach and study participants, we will evaluate the feasibility of research and intervention procedures, and the acceptability of information and support from the peer decision coach. DISCUSSION The peer-delivered decision coaching intervention holds promise for assisting young people with making informed and values-consistent decisions about their care, and potentially enhancing service engagement within this traditionally difficult-to-engage population. If the intervention demonstrates feasibility and acceptability, and pilot data show its potential for improving treatment decision-making, our work will also lay the foundation for a new evidence base regarding roles for peer specialists on early intervention teams. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (Identifier: NCT04532034 ) on 28 August 2020 as Temple University Protocol Record 261047, Facilitating Engagement in Evidence-Based Treatment for Early Psychosis.
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Affiliation(s)
- Elizabeth C Thomas
- Temple University College of Public Health, 1700 N Broad Street, Philadelphia, PA, 19121, USA.
| | - John Suarez
- Temple University College of Public Health, 1700 N Broad Street, Philadelphia, PA, 19121, USA
| | - Alicia Lucksted
- University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA
| | - Laura A Siminoff
- Temple University College of Public Health, 1700 N Broad Street, Philadelphia, PA, 19121, USA
| | - Irene Hurford
- Irene Hurford MD PLLC, 261 Old York Road #925, Jenkintown, PA, 19046, USA
| | - Lisa B Dixon
- Columbia University Department of Psychiatry, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Maria O'Connell
- Yale University School of Medicine, 300 George Street, New Haven, CT, 06511, USA
| | - David L Penn
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, 256 Davie Hall, Chapel Hill, NC, 27514, USA
- Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia
| | - Mark S Salzer
- Temple University College of Public Health, 1700 N Broad Street, Philadelphia, PA, 19121, USA
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How Shared Is Shared Decision Making? Reaching the Full Potential of Patient-Clinician Collaboration in Mental Health. Harv Rev Psychiatry 2021; 29:361-369. [PMID: 34352846 DOI: 10.1097/hrp.0000000000000304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Shared decision making in mental health is a priority for stakeholders, but faces significant implementation barriers, particularly in settings intended to serve people with serious mental illnesses (SMI). As a result, current levels of shared decision making are low. We highlight these barriers and propose that a novel paradigm, collaborative decision making, will offer conceptual and practical solutions at the systemic and patient/clinician level. Collaborative decision making is tailored for populations like people with SMI and other groups who experience chronic and complex symptoms, along with power imbalances within health systems. Advancing from shared decision making to collaborative decision making clarifies the mission of the model: to facilitate an empowering and recovery-oriented decision-making process that assigns equal power and responsibility to patients and clinicians; to improve alignment of treatment decisions with patient values and priorities; to increase patient trust and confidence in clinicians and the treatment process; and, in the end, to improve treatment engagement, satisfaction, and outcomes. The primary purpose of collaborative decision making is to increase values-aligned care, therefore prioritizing inclusion of patient values, including cultural values and quality of life-related outcomes. Given the broad and constantly changing context of treatment and care for many people with SMI (and also other groups), this model is dynamic and continuously evolving, ready for use across diverse contexts. Implementation of collaborative decision making includes increasing patient knowledge but also patient power, comfort, and confidence. It is one tool to reshape patient-clinician and patient-system relationships and to increase access to value-aligned care for people with SMI and other groups.
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Treichler EBH, Rabin BA, Spaulding WD, Thomas ML, Salyers MP, Granholm EL, Cohen AN, Light GA. Skills-based intervention to enhance collaborative decision-making: systematic adaptation and open trial protocol for veterans with psychosis. Pilot Feasibility Stud 2021; 7:89. [PMID: 33781352 PMCID: PMC8005669 DOI: 10.1186/s40814-021-00820-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022] Open
Abstract
Background Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans. Methods In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness. Discussion This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs. Trial registration ClinicalTrials.gov Identifier: NCT04324944
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Affiliation(s)
- Emily B H Treichler
- VA Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA, USA. .,Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA.
| | - Borsika A Rabin
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.,Center of Excellence in Stress and Mental Health, San Diego VA, La Jolla, CA, USA.,UC San Diego Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA
| | | | - Michael L Thomas
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA.,Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA
| | - Eric L Granholm
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA.,VA San Diego Psychology Service, San Diego, CA, USA
| | - Amy N Cohen
- American Psychiatric Association, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Gregory A Light
- VA Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA, USA.,Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA
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Joseph-Williams N, Abhyankar P, Boland L, Bravo P, Brenner AT, Brodney S, Coulter A, Giguere A, Hoffman A, Körner M, Langford A, Légaré F, Matlock D, Moumjid N, Munro S, Dahl Steffensen K, Stirling C, van der Weijden T. What Works in Implementing Patient Decision Aids in Routine Clinical Settings? A Rapid Realist Review and Update from the International Patient Decision Aid Standards Collaboration. Med Decis Making 2020; 41:907-937. [PMID: 33319621 PMCID: PMC8474331 DOI: 10.1177/0272989x20978208] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Decades of effectiveness research has established the benefits of using patient decision aids (PtDAs), yet broad clinical implementation has not yet occurred. Evidence to date is mainly derived from highly controlled settings; if clinicians and health care organizations are expected to embed PtDAs as a means to support person-centered care, we need to better understand what this might look like outside of a research setting. AIM This review was conducted in response to the IPDAS Collaboration's evidence update process, which informs their published standards for PtDA quality and effectiveness. The aim was to develop context-specific program theories that explain why and how PtDAs are successfully implemented in routine healthcare settings. METHODS Rapid realist review methodology was used to identify articles that could contribute to theory development. We engaged key experts and stakeholders to identify key sources; this was supplemented by electronic database (Medline and CINAHL), gray literature, and forward/backward search strategies. Initial theories were refined to develop realist context-mechanism-outcome configurations, and these were mapped to the Consolidated Framework for Implementation Research. RESULTS We developed 8 refined theories, using data from 23 implementation studies (29 articles), to describe the mechanisms by which PtDAs become successfully implemented into routine clinical settings. Recommended implementation strategies derived from the program theory include 1) co-production of PtDA content and processes (or local adaptation), 2) training the entire team, 3) preparing and prompting patients to engage, 4) senior-level buy-in, and 5) measuring to improve. CONCLUSIONS We recommend key strategies that organizations and individuals intending to embed PtDAs routinely can use as a practical guide. Further work is needed to understand the importance of context in the success of different implementation studies.
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Affiliation(s)
| | - Purva Abhyankar
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Laura Boland
- The Ottawa Hospital Research Institute, School of Health Sciences, Ottawa, Canada and Western University, School of Health Studies, London, ON, Canada
| | - Paulina Bravo
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alison T Brenner
- Division of General Medicine and Clinical Epidemiology, University of North Carolina Medical School, Chapel Hill, NC, USA, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Suzanne Brodney
- Informed Medical Decisions Program, Massachusetts General Hospital, Boston, MA, USA
| | | | - Anik Giguere
- Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada
| | - Aubri Hoffman
- Department of Gynaecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Mirjam Körner
- Medical Psychology and Medical Sociology, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany
| | - Aisha Langford
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Université of Laval, Quebec, Canada
| | - Daniel Matlock
- Department of Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Nora Moumjid
- Claude Bernard Lyon 1 University, Léon Bérard Cancer Centre, Lyon, Rhone-Alpes, France
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Karina Dahl Steffensen
- Center for Shared Decision Making, Region of Southern Denmark and Department of Clinical Oncology, Vejle/Lillebaelt University Hospital of Southern Denmark, Vejle, Denmark and Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Trudy van der Weijden
- CAPHRI Care and Public Health Research Institute, Department of Family Medicine, Faculty Health, Medicine and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
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Aoki Y. Shared decision making for adults with severe mental illness: A concept analysis. Jpn J Nurs Sci 2020; 17:e12365. [PMID: 32761783 PMCID: PMC7590107 DOI: 10.1111/jjns.12365] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/08/2020] [Accepted: 06/27/2020] [Indexed: 12/01/2022]
Abstract
AIM Shared decision making for adults with severe mental illness has increasingly attracted attention. However, this concept has not been comprehensively clarified. This review aimed to clarify a concept of shared decision making for adults with severe mental illness such as schizophrenia, depression, and bipolar disorder, and propose an adequate definition. METHODS Rodgers' evolutionary concept analysis was used. MEDLINE, PsychINFO, and CINAHL were searched for articles written in English and published between 2010 and November 2019. The search terms were "psychiatr*" or "mental" or "schizophren*" or "depression" or "bipolar disorder", combined with "shared decision making". In total, 70 articles met the inclusion criteria. An inductive approach was used to identify themes and sub-themes related to shared decision making for adults with severe mental illness. Surrogate terms and a definition of the concept were also described. RESULTS Four key attributes were identified: user-professional relationship, communication process, user-friendly visualization, and broader stakeholder approach. Communication process was the densest attribute, which consisted of five phases: goal sharing, information sharing, deliberation, mutual agreement, and follow-up. The antecedents as prominent predisposing factors were long-term complex illness, power imbalance, global trend, users' desire, concerns, and stigma. The consequences included decision-related outcomes, users' changes, professionals' changes, and enhanced relationship. CONCLUSIONS Shared decision making for adults with severe mental illness is a communication process, involving both user-friendly visualization techniques and broader stakeholders. The process may overcome traditional power imbalance and encourage changes among both users and professionals that could enhance the dyadic relationship.
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Affiliation(s)
- Yumi Aoki
- Psychiatric & Mental Health Nursing, Graduate School of NursingSt. Luke's International UniversityTokyoJapan
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10
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Kerner B, Crisanti AS, DeShaw JL, Ho JMG, Jordan K, Krall RL, Kuntz MJ, Mazurie AJ, Nestsiarovich A, Perkins DJ, Schroeter QL, Smith AN, Tohen M, Volesky E, Zhu Y, Lambert CG. Preferences of Information Dissemination on Treatment for Bipolar Disorder: Patient-Centered Focus Group Study. JMIR Ment Health 2019; 6:e12848. [PMID: 31237566 PMCID: PMC6614999 DOI: 10.2196/12848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/15/2019] [Accepted: 03/29/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Patient education has taken center stage in successfully shared decision making between patients and health care providers. However, little is known about how patients with bipolar disorder typically obtain information on their illness and the treatment options available to them. OBJECTIVE This study aimed to obtain the perspectives of patients with bipolar disorder and their family members on the preferred and most effectively used information channels on bipolar disorder and the available treatment options. METHODS We conducted nine focus groups in Montana, New Mexico, and California, in which we surveyed 84 individuals including patients with bipolar disorder and family members of patients with bipolar disorder. The participants were recruited using National Alliance on Mental Illness mailing lists and websites. Written verbatim responses to semistructured questionnaires were analyzed using summative content analysis based on grounded theory. Two annotators coded and analyzed the data on the sentence or phrase level to create themes. Relationships between demographics and information channel were also examined using the Chi-square and Fisher exact tests. RESULTS The focus group participants mentioned a broad range of information channels that were successfully used in the past and could be recommended for future information dissemination. The majority of participants used providers (74%) and internet-based resources (75%) as their main information sources. There was no association between internet use and basic demographics such as age or geographical region of the focus groups. Patients considered time constraints and the fast pace in which an overwhelming amount of information is often presented by the provider as major barriers to successful provider-patient interactions. If Web-based channels were used, the participants perceived information obtained through Web-based channels as more helpful than information received in the provider's office (P<.05). CONCLUSIONS Web-based resources are increasingly used by patients with bipolar disorder and their family members to educate themselves about the disease and its treatment. Although provider-patient interactions are frequently perceived to be burdened with time constraints, Web-based information sources are considered reliable and helpful. Future research should explore how high-quality websites could be used to empower patients and improve provider-patient interactions with the goal of enhancing shared decision making between patients and providers.
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Affiliation(s)
- Berit Kerner
- Semel Institute, University of California, Los Angeles, CA, United States
| | - Annette S Crisanti
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Jason L DeShaw
- National Alliance on Mental Illness Montana, Helena, MT, United States
| | | | - Kimmie Jordan
- National Alliance on Mental Illness New Mexico, Albuquerque, NM, United States
| | - Ronald L Krall
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Matt J Kuntz
- National Alliance on Mental Illness Montana, Helena, MT, United States
| | | | - Anastasiya Nestsiarovich
- Division of Translational Informatics, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Douglas J Perkins
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | | | - Alicia N Smith
- National Alliance on Mental Illness Montana, Helena, MT, United States
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Emma Volesky
- National Alliance on Mental Illness Montana, Helena, MT, United States
| | - Yiliang Zhu
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Christophe G Lambert
- Division of Translational Informatics, Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
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11
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Williams A, Farhall J, Fossey E, Thomas N. Internet-based interventions to support recovery and self-management: A scoping review of their use by mental health service users and providers together. BMC Psychiatry 2019; 19:191. [PMID: 31221125 PMCID: PMC6585058 DOI: 10.1186/s12888-019-2153-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 05/20/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Internet-based interventions can make self-management and recovery-oriented information and tools more accessible for people experiencing severe mental illness, including psychosis. The aim of this scoping review was to identify and describe emerging joint uses of these Internet-based interventions by service users experiencing psychosis and mental health workers. It also investigated how using these Internet-based interventions influenced interactions between service users and workers and whether recovery-oriented working practices were elicited. METHODS A scoping review method was used. Iterative review stages included identifying the review question, a comprehensive search including searching six electronic databases to locate relevant studies, selecting studies, charting the data, and collating and reporting the results. Rigour of the scoping review was enhanced by using an appraisal tool to evaluate the quality of included studies, and by using a published template for systematic description of interventions. RESULTS Fifteen papers about eleven Internet-based interventions that focused on self-management and/or recovery were identified. Interventions were web-based, mobile-device based, or both. The eleven interventions were used by service users either with their usual mental health workers, or with mental health workers employed in a research project. Emerging evidence suggested that jointly using an Internet-based intervention could support a positive sense of working together. However, mismatched expectations and poor integration of Internet-based interventions into service systems could also negatively influence interactions, leading to mistrust. The interventions demonstrated potential to elicit recognised recovery-oriented practices, specifically understanding service users' values and supporting their goal striving. CONCLUSIONS The use of Internet-based interventions focused on self-management and recovery in mental health services by service users and workers jointly demonstrates potential to support working together and recovery-oriented practice. Given that the quality of relationships is critical in recovery-oriented practice, greater focus on human support in Internet-based interventions is needed in future research and practice.
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Affiliation(s)
- Anne Williams
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne, Victoria, Australia. .,Department of Health Professions, Swinburne University of Technology, Hawthorn, Victoria, Australia.
| | - John Farhall
- 0000 0001 2342 0938grid.1018.8Department of Psychology and Counselling, La Trobe University, Melbourne, Victoria Australia ,0000 0004 0452 651Xgrid.429299.dNorthWestern Mental Health, Melbourne Health, Melbourne, Melbourne, Victoria Australia
| | - Ellie Fossey
- 0000 0004 1936 7857grid.1002.3Department of Occupational Therapy, Monash University, Frankston, Victoria Australia ,0000 0001 2342 0938grid.1018.8Living with Disability Research Centre, La Trobe University, Melbourne, Victoria Australia
| | - Neil Thomas
- 0000 0004 0409 2862grid.1027.4Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria Australia ,0000 0004 0623 9709grid.476960.aMonash Alfred Psychiatry Research Centre, Melbourne, Victoria Australia
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12
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Finnerty M, Austin E, Chen Q, Layman D, Kealey E, Ng-Mak D, Rajagopalan K, Hoagwood K. Implementation and Use of a Client-Facing Web-Based Shared Decision-Making System (MyCHOIS-CommonGround) in Two Specialty Mental Health Clinics. Community Ment Health J 2019; 55:641-650. [PMID: 30317442 PMCID: PMC6447505 DOI: 10.1007/s10597-018-0341-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/01/2018] [Indexed: 11/18/2022]
Abstract
Electronic shared-decision making programs may provide an assistive technology to support physician-patient communication. This mixed methods study examined use of a web-based shared decision-making program (MyCHOIS-CommonGround) by individuals receiving specialty mental health services, and identified qualitative factors influencing adoption during the first 18 months of implementation in two Medicaid mental health clinics. T-tests and χ2 analyses were conducted to assess differences in patient use between sites. Approximately 80% of patients in both clinics created a MyCHOIS-CommonGround user profile, but marked differences emerged between clinics in patients completing shared decision-making reports (79% vs. 28%, χ2(1) = 109.92, p < .01) and average number of reports (7.20 vs. 3.60, t = - 3.64, p < .01). Results suggest high penetration of computer-based programs in specialty mental health services is possible, but clinic implementation factors can influence patient use including leadership commitment, peer staff funding to support the program, and implementation strategy, most notably integration of the program within routine clinical workflow.
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Affiliation(s)
- Molly Finnerty
- New York State Office of Mental Health, 330 5th Ave, New York, NY, 10001, USA.
- New York University Langone Medical Center, One Park Ave, 7th Floor, New York, NY, USA.
| | - Elizabeth Austin
- New York State Office of Mental Health, 330 5th Ave, New York, NY, 10001, USA
- Department of Surgery, University of Washington, 1107 NE 45th Street, Box 354808, Seattle, WA, USA
| | - Qingxian Chen
- New York State Office of Mental Health, 75 New Scotland Ave, CDPC Unit R, Albany, NY, USA
| | - Deborah Layman
- New York State Office of Mental Health, 330 5th Ave, New York, NY, 10001, USA
| | - Edith Kealey
- New York State Office of Mental Health, 330 5th Ave, New York, NY, 10001, USA
- NYC Department of Social Services, 150 Greenwich St., 42nd Floor, New York, NY, USA
| | - Daisy Ng-Mak
- Sunovion Pharmaceuticals Inc., 84 Waterford Drive, Marlborough, MA, 01752, USA
| | | | - Kimberly Hoagwood
- New York University Langone Medical Center, One Park Ave, 7th Floor, New York, NY, USA
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13
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Aref-Adib G, McCloud T, Ross J, O'Hanlon P, Appleton V, Rowe S, Murray E, Johnson S, Lobban F. Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review. Lancet Psychiatry 2019; 6:257-266. [PMID: 30522979 DOI: 10.1016/s2215-0366(18)30302-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/20/2022]
Abstract
Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.
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Affiliation(s)
- Golnar Aref-Adib
- Division of Psychiatry, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, London, UK.
| | - Tayla McCloud
- Division of Psychiatry, University College London, London, UK
| | - Jamie Ross
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Puffin O'Hanlon
- Division of Psychiatry, University College London, London, UK
| | - Victoria Appleton
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, London, UK
| | - Elizabeth Murray
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, London, UK
| | - Fiona Lobban
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
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14
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Noel VA, Acquilano SC, Carpenter-Song E, Drake RE. Use of Mobile and Computer Devices to Support Recovery in People With Serious Mental Illness: Survey Study. JMIR Ment Health 2019; 6:e12255. [PMID: 30785401 PMCID: PMC6401671 DOI: 10.2196/12255] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/20/2018] [Accepted: 12/05/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Mental health recovery refers to an individual's experience of gaining a sense of personal control, striving towards one's life goals, and meeting one's needs. Although people with serious mental illness own and use electronic devices for general purposes, knowledge of their current use and interest in future use for supporting mental health recovery remains limited. OBJECTIVE This study aimed to identify smartphone, tablet, and computer apps that mental health service recipients use and want to use to support their recovery. METHODS In this pilot study, we surveyed a convenience sample of 63 mental health service recipients with serious mental illness. The survey assessed current use and interest in mobile and computer devices to support recovery. RESULTS Listening to music (60%), accessing the internet (59%), calling (59%), and texting (54%) people were the top functions currently used by participants on their device to support their recovery. Participants expressed interest in learning how to use apps for anxiety/stress management (45%), mood management (45%), monitoring mental health symptoms (43%), cognitive behavioral therapy (40%), sleep (38%), and dialectical behavior therapy (38%) to support their recovery. CONCLUSIONS Mental health service recipients currently use general functions such as listening to music and calling friends to support recovery. Nevertheless, they reported interest in trying more specific illness-management apps.
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Affiliation(s)
| | - Stephanie C Acquilano
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, United States
| | | | - Robert E Drake
- Westat, Inc, Lebanon, NH, United States.,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, United States
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15
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[Shared decision-making in acute psychiatric medicine : Contraindication or a challenge?]. DER NERVENARZT 2019; 88:995-1002. [PMID: 28597029 DOI: 10.1007/s00115-017-0359-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The concept of shared decision-making (SDM) has existed since the 1990s in multiple fields of somatic medicine but has only been poorly applied in psychiatric clinical routine despite broad acceptance and promising outcomes in clinical studies on its positive effects. MATERIALS AND METHODS The concept itself and its practicability in mental health are carefully assessed and strategies for its future implementation in psychiatric medicine are presented in this article. Ongoing clinical studies probing some of those strategies are further outlined. RESULTS AND DISCUSSION On top of the ubiquitous shortage of time in clinical routine, psychiatrists report their concern about patients' limited abilities in sharing decisions and their own fear of potentially harmful decisions resulting from a shared process. Misinterpretation of shared decision-making restricting the health care professional to rather an informed choice scenario and their own adhesion to the traditional paternalistic decision-making approach further add to SDM's underutilization. Those hurdles could be overcome by communication skill workshops for all mental health care professionals, including nursing personnels, psychologists, social workers and physicians, as well as the use of decision aids and training courses for patients to motivate and empower them in sharing decisions with the medical staff. By this, the patient-centered treatment approach demanded by guidelines, carers and users could be further facilitated in psychiatric clinical routine.
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16
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Brooks H, Harris K, Bee P, Lovell K, Rogers A, Drake R. Exploring the potential implementation of a tool to enhance shared decision making (SDM) in mental health services in the United Kingdom: a qualitative exploration of the views of service users, carers and professionals. Int J Ment Health Syst 2017; 11:42. [PMID: 28670338 PMCID: PMC5490161 DOI: 10.1186/s13033-017-0149-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/12/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND As a response to evidence that mental health service users and carers expect greater involvement in decisions about antipsychotic medication choice and prescribing, shared decision-making (SDM) has increasingly come to be viewed as an essential element of person-centred care and practice. However, this aspiration has yet to be realised in practice, as service users and carers continue to feel alienated from healthcare services. Existing understanding of the factors affecting the use of tools to support SDM is limited to inter-individual influences and wider factors affecting potential implementation are underexplored. AIM To explore the potential use of a tool designed to enhance collaborative antipsychotic prescribing from the perspectives of secondary care mental health service users, carers and professionals. METHODS We conducted a qualitative study (semi-structured interviews and focus groups) using a convenience sample of 33 participants (10 mental health service users, 10 carers and 13 professionals) involved in antipsychotic prescribing in one Trust in the North of England. Participants were asked about the potential implementation of a tool to support SDM within secondary mental health services. Framework analysis incorporating the use of constant comparative method was used to analyse the data. RESULTS The study identified a divergence in the views of service users and professionals, including a previously undocumented tendency for stakeholder groups to blame each other for potential implementation failure. This dissonance was shaped by meso and macro level influences relating to paternalism, legislative frameworks, accountability and lack of resources. Participants did not identify any macro level (policy or structural) facilitators to the use of the tool highlighting the negative impact of mental health contexts. Our study indicated that inter-individual factors are likely to be most important to implementation, given their potential to transcend meso and macro level barriers. CONCLUSIONS Consideration of the meso and macro level influences identified areas for potential intervention, including challenging professionals' and service users' perceptions of each other, rebalancing the notion of accountability within services and introducing new means for service user feedback on the quality of SDM. Multi-level strategies for facilitating the implementation of tools to support SDM are also presented.
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Affiliation(s)
- Helen Brooks
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Kamelia Harris
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Penny Bee
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Karina Lovell
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Richard Drake
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Room 3.315 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
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17
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Salyers MP, Fukui S, Bonfils KA, Firmin RL, Luther L, Goscha R, Rapp CA, Holter MC. Consumer Outcomes After Implementing CommonGround as an Approach to Shared Decision Making. Psychiatr Serv 2017; 68:299-302. [PMID: 27903137 PMCID: PMC5658777 DOI: 10.1176/appi.ps.201500468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined consumer outcomes before and after implementing CommonGround, a computer-based shared decision-making program. METHODS Consumers with severe mental illness (N=167) were interviewed prior to implementation and 12 and 18 months later to assess changes in active treatment involvement, symptoms, and recovery-related attitudes. Providers also rated consumers on level of treatment involvement. RESULTS Most consumers used CommonGround at least once (67%), but few used the program regularly. Mixed-effects regression analyses showed improvement in self-reported symptoms and recovery attitudes. Self-reported treatment involvement did not change; however, for a subset of consumers with the same providers over time (N=83), the providers rated consumers as more active in treatment. CONCLUSIONS This study adds to the growing literature on tools to support shared decision making, showing the potential benefits of CommonGround for improving recovery outcomes. More work is needed to better engage consumers in CommonGround and to test the approach with more rigorous methods.
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Affiliation(s)
- Michelle P Salyers
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Sadaaki Fukui
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Kelsey A Bonfils
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Ruth L Firmin
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Lauren Luther
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Rick Goscha
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Charles A Rapp
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
| | - Mark C Holter
- Dr. Salyers, Ms. Bonfils, Ms. Firmin, and Ms. Luther are with the Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis (e-mail: ). Dr. Fukui, Dr. Goscha, and Dr. Rapp are with the School of Social Welfare, University of Kansas, Lawrence, where Dr. Holter was affiliated when this work was done
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