Shared decision-making reduces drug use and psychiatric severity in substance-dependent patients.
BACKGROUND
In the last decades, shared decision-making (SDM) models have been developed to increase patient involvement in treatment decisions. The purpose of this study was to evaluate a SDM intervention (SDMI) for patients dependent on psychoactive substances in addiction health care programs. The intervention consisted of a structured procedure to reach a treatment agreement and comprised 5 sessions.


METHODS
Clinicians in 3 treatment centres in the Netherlands were randomly assigned to the SDMI or a standard procedure to reach a treatment agreement.


RESULTS
A total of 220 substance-dependent patients receiving inpatient treatment were randomised either to the intervention (n = 111) or control (n = 109) conditions. Reductions in primary substance use (F((1, 124)) = 248.38, p < 0.01) and addiction severity (F((8)) = 27.76, p < 0.01) were found in the total population. Significant change was found in the total population regarding patients' quality of life measured at baseline, exit and follow-up (F((2, 146)) = 5.66, p < 0.01). On the European Addiction Severity Index, SDMI showed significantly better improvements than standard decision-making regarding drug use (F((1, 164)) = 7.40, p < 0.01) and psychiatric problems (F((1, 164)) = 5.91, p = 0.02) at 3-month follow-up.


CONCLUSIONS
SDMI showed a significant add-on effect on top of a well-established 3-month inpatient intervention. SDMI offers an effective, structured, frequent and well-balanced intervention to carry out and evaluate a treatment agreement.
Joosten
E A G
EA
Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands. evelien.joosten@gmail.com
de Jong
C A J
CA
de Weert-van Oene
G H
GH
Sensky
T
T
van der Staak
C P F
CP
D000328:Adult; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011340:Problem Solving; D011615:Psychotherapy, Group; D011619:Psychotropic Drugs; D011779:Q-Sort; D011788:Quality of Life / Q000523:psychology; D012917:Social Adjustment; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires
D011619:Psychotropic Drugs