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To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

Authors De las Cuevas C, Peñate W, de Rivera L

Received 21 August 2014

Accepted for publication 29 September 2014

Published 4 November 2014 Volume 2014:8 Pages 1547—1553


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Carlos De las Cuevas,1 Wenceslao Peñate,2 Luis de Rivera3

1Department of Internal Medicine, Dermatology and Psychiatry, 2Department of Personality, Assessment and Psychological Treatments, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, 3Department of Psychiatry, University Autónoma de Madrid, Madrid, Spain

Rationale: Nonadherence to prescribed medications is a significant barrier to the successful treatment of psychiatric disorders in clinical practice. It has been argued that patient participation in shared decision making improves adherence to treatment plans.
Purpose: To assess to what extent treatment adherence of psychiatric patients is influenced by the concordance between their preferred participation and their actual participation in decision making.
Materials and methods: A total of 967 consecutive psychiatric outpatients completed the Control Preference Scale twice consecutively before consultation, one for their preferences of participation, and the other for the style they had usually experienced until then, and the eight-item self-report Morisky Medication Adherence Scale 8.
Results: Most psychiatric outpatients preferred a collaborative role in decision making. Congruence was achieved in only 50% of the patients, with most mismatch cases preferring more involvement than had been experienced. Self-reported adherence was significantly higher in those patients in whom there was concordance between their preferences and their experiences of participation in decision making, regardless of the type of participation preferred.
Conclusion: Congruence between patients’ preferences and actual experiences for level of participation in shared decision making is relevant for their adherence to treatment.

treatment adherence, psychiatric outpatients, shared decision making

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