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)

Abstract

BackgroundTo 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.MethodsA 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.ResultsNo 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.ConclusionThe 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.