Shared Decision-Making: a Systematic Review Focusing on Mood Disorders
- 226 Downloads
Purpose of Review
This study aims to provide a review of the randomized controlled studies evaluating the effects of shared decision-making (SDM) intervention in comparison to care as usual in patients with mood disorders.
Of the 14 randomized controlled studies identified, only three 6-month studies evaluated the interest of SDM interventions using decision aids in depressed patients. All of them showed that the intervention effectively improved patient satisfaction and engagement in the decision-making process. Only one study in patients with bipolar disorder (BD) showed improvement of depressive symptoms, functioning, and quality of life. Other included studies were collaborative care interventions using a SDM approach in patients with depression in specific populations depending on age, gender, income, and physical comorbidities. All of them showed significant improvement in depression outcomes or medication adherence.
SDM interventions using decision aids and collaborative care showed evidence of improvements in the management of depression. Stronger evidence of SDM interest in BD is needed.
KeywordsShared decision-making Collaborative care Major depressive disorder Bipolar disorder Mood disorder
Compliance with Ethical Standards
Conflict of Interest
Jean-Baptiste Genty, Laurent Boyer, Jorge Lopez-Castroman, and Mocrane Abbar declare no conflict of interest.
Ludovic Samalin has received grants, honoraria, or consulting fees from AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Lundbeck, Otsuka, Sanofi-Aventis, and Takeda.
Pierre-Michel Llorca has received grants, honoraria, or consulting fees from AstraZeneca, Bristol-Myers Squibb, Janssen-Cilag, Lundbeck, and Otsuka.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 8.Sheehan DV, Keene MS, Eaddy M, Krulewicz S, Kraus JE, Carpenter DJ. Differences in medication adherence and healthcare resource utilization patterns: older versus newer antidepressant agents in patients with depression and/or anxiety disorders. CNS Drugs. 2008;22(11):963–73.CrossRefPubMedGoogle Scholar
- 12.Tuckett D, Boulton M, Olson C, Williams A. Meeting between experts: an approach to sharing ideas in medical consultations. New York: Routledge; 1986.Google Scholar
- 13.Duncan E, Best C, Hagen S. Shared decision making interventions for people with mental health conditions. Cochrane Database Syst Rev. 2010;1:CD007297.Google Scholar
- 15.•• Fisher A, Manicavasagar V, Klin F, Juraskova I. Communication and decision-making in mental health: a systematic review focusing on bipolar disorder. Patient Educ Couns. 2016;99(7):1106–20. Very comprehensive review of studies of communication and decision-making in mental health-based samples including BD patients. CrossRefPubMedGoogle Scholar
- 17.•• LeBlanc A, Herrin J, Williams MD, Inselman JW, Branda ME, Shah ND et al. Shared decision making for antidepressants in primary care: a cluster randomized trial. JAMA Intern Med. 2015;175(11):1761–70. One of the major studies evaluating a SDM intervention in MDD patients. Google Scholar
- 20.•• van der Voort TY, van Meijel B, Goossens PJ, Hoogendoorn AW, Draisma S, Beekman A, et al. Collaborative care for patients with bipolar disorder: randomised controlled trial. Br J Psychiatry. 2015;206(5):393–400. The only available study evaluating a collaborative care intervention that included a SDM approach for BD patients. CrossRefPubMedGoogle Scholar
- 23.Unützer J, Katon W, Callahan CM, Williams JW Jr, Hunkeler E, Harpole L, et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA 2002;288(22):2836–2845.Google Scholar
- 25.Katon W, Russo J, Reed SD, Croicu CA, Ludman E, LaRocco A, et al. A randomized trial of collaborative depression care in obstetrics and gynecology clinics: socioeconomic disadvantage and treatment response. Am J Psychiatry 2015;172(1):32–40Google Scholar
- 33.Unützer J, Katon W, Williams JW Jr, Callahan CM, Harpole L, Hunkeler EM et al. Improving primary care for depression in late life: the design of a multicenter randomized trial. Med Care 2001;39(8):785–799.Google Scholar
- 34.• Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;(1):CD001431. Comprehensive review on decision aids for people facing health treatment or screening decisions. Google Scholar