Shared decision making in psychiatric practice and the primary care setting is unique, as measured using a 9-item Shared Decision Making Questionnaire (SDM-Q-9)

Carlos De las Cuevas,^1,2 Wenceslao Peñate,³ Lilisbeth Perestelo-Pérez,^2,4 Pedro Serrano-Aguilar<sup>2,4

1</sup>Department of Psychiatry, University of La Laguna, Tenerife, Spain; ²Health Services Research Network for Chronic Diseases (REDISSEC), Tenerife, Spain; ³Department of Personality, Assessment and Psychological Treatments, University of La Laguna, Tenerife, Spain; ⁴Evaluation Unit, Canary Island Health Service, Santa Cruz de Tenerife, Spain

Background: To measure and compare the extent to which shared a decision making (SDM) process is implemented both in psychiatric outpatient clinical encounters and in the primary care setting from the patient’s perspective.
Methods: A total of 1,477 patients recruited from the Canary Islands Health Service mental health and primary care departments were invited to complete the nine-item Shared Decision Making Questionnaire (SDM-Q-9) immediately after their consultation. MANCOVA, Student’s t-test, and Pearson correlations were used to assess the relationship and differences between SDM-Q-9 scores in patient samples.
Results: No differences were found in SDM-Q-9 total scores between the two patient samples, but there were relevant differences when item by item analysis was applied; differences were observed according to the different steps of the SDM process. SDM is present to a very limited extent in the routine psychiatric setting compared to primary care. Patients’ age, education, type of appointment, and treatment decision all play a specific role in predicting SDM.
Conclusion: The study provides evidence that SDM is a complex process that needs to be analyzed according to its different steps. SDM patterns were different in the primary care and psychiatric outpatient care settings and reflect quite a different perspective of the decision making process.

Keywords: primary care patients, psychiatric outpatients, SDM-Q-9, shared decision making