Psychiatric Providers' Willingness to Participate in Shared Decision Making When Prescribing Psychotropics

Abstract

Background: Patients with mental health disorders experience difficulty in selecting treatments. With a paternalistic approach, patients are not offered an opportunity to provide input. Shared decision making (SDM) occurs when providers and patients collaborate on informed treatment decisions. Research on psychiatric providers' perceptions toward SDM is limited. Objective: This pilot study aimed to determine psychiatric providers' willingness to engage in SDM and factors that influence willingness. Methods: This cross-sectional, self-report study measured willingness, attitude, experiences, and barriers related to SDM as well as demographic/practice characteristics. A survey was e-mailed to psychiatric providers at 3 psychiatric institutions. Results: Out of 80 providers e-mailed, 29 (36.3%) responded. Providers had a favorable attitude toward SDM (3.26 ± 0.24, range = 1-4) and a high willingness to use SDM (3.43 ± 0.50, range = 1-4). The most common SDM methods were discussions (96.6%) and written material (89.7%). Common perceived barriers included limited patient capacity (86.2%) and limited time with patient (62.1%). Current SDM users (3.46 ± 0.51) had a higher willingness to engage in SDM than noncurrent users (3.00 ± 0.00), t = 4.63, df = 25.0, P < .001. Attitude and willingness were positively related (r = .62, P < .001). Attitude did not vary based on demographic/practice characteristics. Conclusions: Willingness to use SDM was positively related to a favorable attitude toward SDM. Larger, geographically diverse, randomized controlled trials need to be conducted to evaluate the willingness of psychiatric providers to conduct SDM.

Keywords: adherence; communication; counseling; mental health; patient education; pharmacist/physician issues; psychiatry.