Best practices: a program to support shared decision making in an outpatient psychiatric medication clinic.

This column presents preliminary findings of an intervention to support shared decision making in psychopharmacology consultation. The waiting area in an urban psychiatric medication clinic was transformed into a peer-run Decision Support Center featuring a user-friendly, Internet-based software program with which clients could create a one-page computer-generated report for use in the medication consultation. The Decision Support Center was used 662 times by 189 unique users from a young-adult and general adult case management team from October 2006 to September 2007. All clients had severe mental disorders. Only ten clients refused to use the intervention at some point during the pilot study. Focus groups with medical staff (N=4), clients (N=16), case managers (N=14), and peer-specialist staff (N=3) reported that the intervention helped to create efficiencies in the consultation and empower clients to become more involved in treatment-related decision making. A randomized controlled trial is currently in process.

[1]  Dawn Stacey,et al.  An evidence-based approach to managing women's decisional conflict. , 2002, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[2]  P Kinnersley,et al.  Shared decision making and the concept of equipoise: the competences of involving patients in healthcare choices. , 2000, The British journal of general practice : the journal of the Royal College of General Practitioners.

[3]  France Légaré,et al.  Risk communication in practice: the contribution of decision aids , 2003, BMJ : British Medical Journal.

[4]  P. Deegan The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support it. , 2007, Psychiatric rehabilitation journal.

[5]  Robert E. Drake,et al.  Shared Decision-Making and Evidence-Based Practice , 2006, Community Mental Health Journal.

[6]  Robert E Drake,et al.  Shared decision making and medication management in the recovery process. , 2006, Psychiatric services.