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Social Psychiatry and Psychiatric Epidemiology

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01-02-2017 | Original Paper

Training patients with schizophrenia to share decisions with their psychiatrists: a randomized-controlled trial

Authors: Johannes Hamann, Anna Parchmann, Nina Sassenberg, Katharina Bronner, Margot Albus, Alwin Richter, Sandra Hoppstock, Werner Kissling

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2017

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.

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Title: Training patients with schizophrenia to share decisions with their psychiatrists: a randomized-controlled trial
Authors: Johannes Hamann
Anna Parchmann
Nina Sassenberg
Katharina Bronner
Margot Albus
Alwin Richter
Sandra Hoppstock
Werner Kissling
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 2/2017
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-016-1327-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Training patients with schizophrenia to share decisions with their psychiatrists: a randomized-controlled trial

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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