Best Practices: A Program to Support Shared Decision Making in an Outpatient Psychiatric Medication Clinic

TLDR

The study involved clients with severe mental disorders. The waiting area was converted into a peer‑run Decision Support Center with user‑friendly Internet software that generates a one‑page report for consultations, and a randomized controlled trial is underway. The intervention was used 662 times by 189 unique clients, with only ten refusals, and focus groups reported increased consultation efficiency and client empowerment.

Abstract

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.