Title: Developing and evaluating a shared decision making intervention for service users and professionals focused on psychiatric medication management
Funder: Department of Health (England)

Abstract: Background Shared decision making (SDM) is perceived as a positive practice in primary care (1) and in mental health (2), but is rarely applied or evaluated. The proposed project aims to introduce and evaluate a shared decision making process and decision making aids to current psychiatric medication prescription and management practice, as the cornerstone to improving concordance (3, 4). This project will focus on an intervention that enables users and providers to be active partners in the decision making process regarding psychiatric medication, drawing on programmes developed in the US (5) and Denmark (6). A mixed methods research methodology will be applied to evaluate its impact for patients. Aims The main aim is to develop and evaluate the feasibility, acceptability and impact of an intervention for service users and clinicians to encourage SDM in psychiatric medication management. Specific objectives are: Review internationally existing initiatives designed to encourage SDM in psychiatric medication management. Develop an intervention designed to promote SDM processes in relation to psychiatric medication management, which draws on the scoping review results and consultations with local relevant stakeholders. Deliver an intervention designed to promote SDM in psychiatric medication management in adult community psychiatric services to service users, psychiatrists and CPNs. Evaluate the impact of the intervention using a mixed-methods process and outcome-oriented approach. Plan of Investigation Module 1: Scoping review (1-6 months) Module 2: Intervention development (5-12 m) drawing on the review and consultations with key stakeholders. Module 3: Implementation (13-18 m) Participants will be service users (n=70), psychiatrists (n=10) and CPNs (n=12). Each group will be invited to a series of interactive group sessions, complemented by e-learning tools, individualised support for service users and follow-up contacts. Module 4: Evaluation (13-36 m) A mixed-methods process and outcome-oriented approach within a before and after uncontrolled design will be used to assess: impact on decision-making relating to medication management and other associated benefits; feasibility, acceptability and participant experiences of the intervention; health economic benefits. Potential Impact If our intervention is shown to have a beneficial impact locally, it will provide an evidence-based intervention with tangible benefits especially for service users, but also for professionals and organisations alike. It is hoped that service users will become more informed and actively involved in their medication management, which may in turn enhance therapeutic relationships and promote recovery. Professionals may gain better understandings of individual patients’ needs and concerns. Findings could inform a subsequent randomised trial to further evaluate the intervention. If successful, the intervention has the potential to generate cost savings. Delivery cost is small and is likely to be offset by significant benefits and associated cost savings.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;7.3 MANAGEMENT AND DECISION MAKING
Health categories: MENTAL HEALTH