Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Feb 6;17(1):52.
doi: 10.1186/s12888-017-1218-1.

Feasibility and efficacy of shared decision making for first-admission schizophrenia: a randomized clinical trial

Mio Ishii  1 , Yasuyuki Okumura  2 , Naoya Sugiyama  3 , Hana Hasegawa  3 , Toshie Noda  3 , Yoshio Hirayasu  1 , Hiroto Ito  4
Affiliations
Randomized Controlled Trial

Feasibility and efficacy of shared decision making for first-admission schizophrenia: a randomized clinical trial

Mio Ishii et al. BMC Psychiatry. .

Abstract

Background: The feasibility of shared decision making (SDM) for patients with schizophrenia remains controversial due to the assumed inability of patients to cooperate in treatment decision making. This study evaluated the feasibility and efficacy of SDM in patients upon first admission for schizophrenia.

Methods: This was a randomized, parallel-group, two-arm, open-label, single-center study conducted in an acute psychiatric ward of Numazu Chuo Hospital, Japan. Patients with the diagnosis of schizophrenia upon their first admission were randomized into a SDM intervention group or a usual treatment group in a 1:1 ratio. The primary outcome was patient satisfaction at discharge. The secondary outcomes were attitudes toward medication at discharge and treatment continuation at 6 months after discharge.

Results: Twenty-four patients were randomly assigned. The trial was prematurely terminated due to slow enrollment. At discharge, the mean score on satisfaction was 23.7 in the SDM group and 22.1 in the usual care group (unadjusted mean difference: 1.6; 95% CI: -5.2 to 2.0). Group differences were not observed in attitude toward medication and treatment continuation. There was no statistically significant difference between the groups for the mean Global Assessment of Functioning score at discharge or length of stay as safety endpoint.

Conclusions: No statistical differences were found between the SDM group and usual care group in the efficacy outcomes and safety endpoints. Large trials are needed to confirm the efficacy of the SDM program upon first admission for schizophrenia.

Trial registration: The study has been registered with ClinicalTrials.gov as NCT01869660 (registered 27 May, 2013).

Keywords: Inpatient treatment; Pilot study; Randomized controlled trial; SDM; Schizophrenia; Shared decision making.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram. SDM = shared decision making.†Some patients met 1 > criterion
See this image and copyright information in PMC

References

    1. Laine C, Davidoff F. Patient-centered medicine. A professional evolution. JAMA. 1996;275:152–6. doi: 10.1001/jama.1996.03530260066035. - DOI - PubMed
    1. Truog RD. Patients and doctors-evolution of a relationship. N Engl J Med. 2012;366:581–5. doi: 10.1056/NEJMp1110848. - DOI - PubMed
    1. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango) Soc Sci Med. 1997;44:681–92. doi: 10.1016/S0277-9536(96)00221-3. - DOI - PubMed
    1. Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Légaré F, Thomson R. Decision aids for people facing health treatment or screening decisions. Cochrane database Syst Rev. 2011;10:CD001431. - PubMed
    1. Hamann J, Heres S. Adapting shared decision making for individuals with severe mental illness. Psychiatr Serv. 2014;65:1483–6. doi: 10.1176/appi.ps.201400307. - DOI - PubMed

Publication types

Associated data