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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.

Psychiatric Services (Washington, D.C.)

|September 26, 2017

Summary

This study found that a shared decision-making system improved patient-doctor relationships in mental health care but did not significantly impact clinical outcomes. The system enhanced communication and collaboration between patients and healthcare providers.

Area of Science:

Mental Health Research
Health Services Research
Patient-Centered Care

Background:

Shared decision-making (SDM) is crucial for patient-centered mental health care.
Integrating peer support and decision aids can enhance SDM processes.
Evaluating novel SDM systems is essential for improving patient outcomes.

Purpose of the Study:

To investigate the effects of a comprehensive SDM system on patients with mental illness.
To assess the implementation of the CommonGround approach, peer support, and a computerized decision aid.
To compare outcomes between an SDM intervention group and a usual care control group.

Main Methods:

A pilot randomized controlled trial (RCT) with 56 outpatients in Japan.
Six-month follow-up period to assess outcomes.
Random allocation to either the SDM system (intervention) or treatment as usual (control).

Main Results:

SDM components and processes were more frequent in the intervention group.
Patients in the intervention group reported significantly better views of their doctor relationship.
No significant effects were observed on most clinical and recovery-related outcomes.

Conclusions:

The SDM system partially improved patient perceptions of communication and doctor relationships.
The intervention did not yield significant improvements in broader patient-level outcomes.
Further research may be needed to optimize SDM systems for comprehensive outcome improvement.

Keywords:

Outpatient treatment Patient advocacy Randomized controlled trial Recovery Staff relationships/roles

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