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Efficacy of a Peer-Led, Recovery-Oriented Shared Decision-Making System: A Pilot Randomized Controlled Trial
Sosei Yamaguchi1, Ayano Taneda1, Asami Matsunaga1
1Dr. Yamaguchi, Dr. Taneda, Ms. Matsunaga, Ms. Sasaki, Dr. Mizuno, and Dr. Ito are with the Department of Psychiatric Rehabilitation, National Center of Neurology and Psychiatry, National Institute of Mental Health, Kodaira, Tokyo. Ms. Sawada is with the Graduate School of Social Welfare, Japan College of Social Work, Kiyose, Tokyo. Dr. Sakata is with the Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Kodaira, Tokyo. Dr. Fukui is with the Department of Educational Psychology, Tokyo Gakugei University, Koganei, Tokyo. Ms. Hisanaga is with the Community Mental Health and Welfare Bonding Organization, Ichikawa, Chiba, Japan. Mr. Bernick is with the Student Accessibility Office, Nagasaki University, Nagasaki, Nagasaki, Japan.
Objective:
The effects of a comprehensive shared decision-making system based on the CommonGround approach and incorporating peer support and a computerized decision aid were investigated.
Methods:
A pilot randomized controlled trial with six-month follow-up was conducted in Japan. Fifty-six outpatients with mental illness were randomly allocated to a shared decision-making system (intervention) group or treatment as usual (control) group. The implementation process and several outcomes were compared between groups.
Results:
The core components and processes of shared decision making were observed in the intervention group more frequently than in the control group. The intervention group also reported a significantly more positive participants' view of the relationship with their doctor than the control group. The intervention did not have a significant effect on most clinical and recovery-related outcomes.
Conclusions:
The shared decision-making system appeared to partly improve patients' perceptions of communication and relationships with doctors but did not have a significant effect on other patient-level outcomes.
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