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Use of a Computerized Medication Shared Decision Making Tool in Community Mental Health Settings: Impact on Psychotropic Medication Adherence

Community Mental Health Journal volume 49, pages 185–192 (2013)Cite this article

Abstract

Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

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Acknowledgments

This research was funded by Community Care Behavioral Health Organization and the West Foundation. The authors would like to thank Laura Greenberg and Amanda Ayers for assistance in manuscript preparation.

Conflict of interest

Dr. Deegan is the owner of the CommonGround software program. The remaining authors have no interests to disclose.

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Authors and Affiliations

  1. RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA

    Bradley D. Stein

  2. UPMC Center for High Value Health Care, U.S. Steel Tower, 9th Fl., 600 Grant Street, Pittsburgh, PA, 15219, USA

    Jane N. Kogan

  3. Community Care Behavioral Health Organization, One Chatham Center, 112 Washington Place, Suite 700, Pittsburgh, PA, 15219, USA

    Mark J. Mihalyo, James Schuster & Mark J. Sorbero

  4. 17 Forest Street, Byfield, MA, USA

    Patricia E. Deegan

  5. Dartmouth Psychiatric Research Center, Rivermill Commercial Center, 85 Mechanic Street Suite B4-1, Lebanon, NH, 03766, USA

    Robert E. Drake

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  1. Bradley D. Stein
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  2. Jane N. Kogan
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  3. Mark J. Mihalyo
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  4. James Schuster
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  5. Patricia E. Deegan
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  6. Mark J. Sorbero
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  7. Robert E. Drake
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Correspondence to Bradley D. Stein.

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Stein, B.D., Kogan, J.N., Mihalyo, M.J. et al. Use of a Computerized Medication Shared Decision Making Tool in Community Mental Health Settings: Impact on Psychotropic Medication Adherence. Community Ment Health J 49, 185–192 (2013). https://doi.org/10.1007/s10597-012-9528-8

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  • DOI: https://doi.org/10.1007/s10597-012-9528-8

Keywords

  • Psychotropic medication
  • Medication adherence
  • Shared-decision making
  • Computer intervention
  • Recovery