No evidence shared decision making improves clinical outcomes

While there is no evidence that shared decision making (SDM) in metal health improves clinical outcomes, it may increase patient satisfaction, a Cochrane review finds. “Given the ethical arguments in support of shared decision making we would recommend that practitioners continue to try and engage patients collaboratively in the treatment decision making process,” the researchers concluded. The review included two German studies involving 518 participants. One of the studies involved inpatient treatment of schizophrenia and the other involved patients with newly diagnosed depression in primary care. Neither study found positive effects of SDM on clinical outcomes, one of the studies identified a statistically significant increase in levels of satisfaction in the intervention group, the review authors reported. There was some evidence that SDM interventions did not cause harm, increase consultation time or affect patient compliance with their treatment plan. Whilst the lack of a sufficient number of high quality studies makes drawing firm conclusions impossible, two null results on the effect of clinical outcomes suggests that SDM does not have a large effect on clinical outcomes, the review authors said. However, they noted that some commentators had questioned whether clinical outcomes were an appropriate outcome measure for SDM interventions. “Why should SDM interventions affect clinical outcomes at all? Some argue that it is enough for SDM interventions to change the nature of the physician-patient interaction and they should not be expected to influence ‘hard’ biological outcomes,” they wrote....