Shared decision making for psychiatric medication management: beyond the micro‐social
Background Mental health care has lagged behind other health‐care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self‐management and recovery‐oriented practice, and growing poli...
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Veröffentlicht in: | Health expectations : an international journal of public participation in health care and health policy 2016-10, Vol.19 (5), p.1002-1014 |
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container_title | Health expectations : an international journal of public participation in health care and health policy |
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creator | Morant, Nicola Kaminskiy, Emma Ramon, Shulamit |
description | Background
Mental health care has lagged behind other health‐care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self‐management and recovery‐oriented practice, and growing policy‐level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs.
Objectives
This conceptual review argues that several aspects of mental health care that differ from other health‐care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health‐care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro‐social focus of a medical consultation. Contextualizing specific medication‐related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM.
Conclusion
A broad conceptualization of decision making for psychiatric medication that moves beyond the micro‐social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care. |
doi_str_mv | 10.1111/hex.12392 |
format | Article |
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Mental health care has lagged behind other health‐care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self‐management and recovery‐oriented practice, and growing policy‐level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs.
Objectives
This conceptual review argues that several aspects of mental health care that differ from other health‐care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health‐care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro‐social focus of a medical consultation. Contextualizing specific medication‐related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM.
Conclusion
A broad conceptualization of decision making for psychiatric medication that moves beyond the micro‐social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care.</description><identifier>ISSN: 1369-6513</identifier><identifier>EISSN: 1369-7625</identifier><identifier>DOI: 10.1111/hex.12392</identifier><identifier>PMID: 26260361</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Analysis ; Clinical decision making ; Clinical medicine ; Coercion ; Collaboration ; Consultation ; Decision Making ; doctor–patient communication ; Domains ; Drug dosages ; Drugs ; Empowerment ; Group decision making ; Health care ; Health services ; Humans ; Insight ; Knowledge ; Medical research ; Mental disorders ; Mental Disorders - drug therapy ; Mental health ; Mental health care ; Mental health services ; Patient compliance ; patient involvement ; Patient Participation ; Patient satisfaction ; Prescribing ; Prescription writing ; Primary care ; Professional-Patient Relations ; psychiatric medication ; psychiatry ; Psychotropic drugs ; Recovery ; Review ; Selfmanagement ; Shape recognition ; shared decision making ; Side effects ; Social background ; Systematic review</subject><ispartof>Health expectations : an international journal of public participation in health care and health policy, 2016-10, Vol.19 (5), p.1002-1014</ispartof><rights>2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.</rights><rights>COPYRIGHT 2015 John Wiley & Sons, Inc.</rights><rights>Copyright © 2016 John Wiley & Sons Ltd</rights><rights>2016. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6782-1adbbff35da5082076207ad4e255fc33ef3e54049f3006bba566b7b49457412b3</citedby><cites>FETCH-LOGICAL-c6782-1adbbff35da5082076207ad4e255fc33ef3e54049f3006bba566b7b49457412b3</cites><orcidid>0000-0003-4022-8133</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053275/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053275/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,12846,27924,27925,30999,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26260361$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morant, Nicola</creatorcontrib><creatorcontrib>Kaminskiy, Emma</creatorcontrib><creatorcontrib>Ramon, Shulamit</creatorcontrib><title>Shared decision making for psychiatric medication management: beyond the micro‐social</title><title>Health expectations : an international journal of public participation in health care and health policy</title><addtitle>Health Expect</addtitle><description>Background
Mental health care has lagged behind other health‐care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self‐management and recovery‐oriented practice, and growing policy‐level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs.
Objectives
This conceptual review argues that several aspects of mental health care that differ from other health‐care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health‐care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro‐social focus of a medical consultation. Contextualizing specific medication‐related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM.
Conclusion
A broad conceptualization of decision making for psychiatric medication that moves beyond the micro‐social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care.</description><subject>Analysis</subject><subject>Clinical decision making</subject><subject>Clinical medicine</subject><subject>Coercion</subject><subject>Collaboration</subject><subject>Consultation</subject><subject>Decision Making</subject><subject>doctor–patient communication</subject><subject>Domains</subject><subject>Drug dosages</subject><subject>Drugs</subject><subject>Empowerment</subject><subject>Group decision making</subject><subject>Health care</subject><subject>Health services</subject><subject>Humans</subject><subject>Insight</subject><subject>Knowledge</subject><subject>Medical research</subject><subject>Mental disorders</subject><subject>Mental Disorders - drug therapy</subject><subject>Mental health</subject><subject>Mental health care</subject><subject>Mental health services</subject><subject>Patient compliance</subject><subject>patient involvement</subject><subject>Patient Participation</subject><subject>Patient satisfaction</subject><subject>Prescribing</subject><subject>Prescription writing</subject><subject>Primary care</subject><subject>Professional-Patient Relations</subject><subject>psychiatric medication</subject><subject>psychiatry</subject><subject>Psychotropic drugs</subject><subject>Recovery</subject><subject>Review</subject><subject>Selfmanagement</subject><subject>Shape recognition</subject><subject>shared decision making</subject><subject>Side effects</subject><subject>Social background</subject><subject>Systematic review</subject><issn>1369-6513</issn><issn>1369-7625</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9ks1u1DAQxyMEoh9w4AVQJC70sFt_xHbCAamqCkWqxAEQ3CzHGW9cEnuxs8DeeASekSdhSpZCEWAfbNm_-c_f4ymKB5QsKY7jHj4vKeMNu1XsUy6bhZJM3N7tpaB8rzjI-ZIQqnit7hZ7TDJJuKT7xdtXvUnQlR1Yn30M5Wje-7AqXUzlOm9t782UvC1H6Lw100wEs4IRwvSkbGEbQ1dOPZSjtyl--_I1R-vNcK-448yQ4f5uPSzePDt7fXq-uHj5_MXpycXCSlWzBTVd2zrHRWcEqRlB40SZrgImhLOcg-MgKlI1jhMi29YIKVvVVk0lVEVZyw-Lp7PuetOiR4uukhn0OvnRpK2OxuubN8H3ehU_akEEZ0qgwOOdQIofNpAnPfpsYRhMgLjJmqIrSUhdKUQf_YFexk0K-DzNWENoJTip_kfRmjYN5YLQX9TKDKB9cBHd2avU-kRRomqO5UFq-RcKZwdY7hjAeTy_EXA0B-Bf5JzAXVeCEn3VKxp7Rf_oFWQf_l66a_JncyBwPAOfMMv230r6_OzdLPkdqhnHew</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Morant, Nicola</creator><creator>Kaminskiy, Emma</creator><creator>Ramon, Shulamit</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>3V.</scope><scope>7RV</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4022-8133</orcidid></search><sort><creationdate>201610</creationdate><title>Shared decision making for psychiatric medication management: beyond the micro‐social</title><author>Morant, Nicola ; Kaminskiy, Emma ; Ramon, Shulamit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6782-1adbbff35da5082076207ad4e255fc33ef3e54049f3006bba566b7b49457412b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Analysis</topic><topic>Clinical decision making</topic><topic>Clinical medicine</topic><topic>Coercion</topic><topic>Collaboration</topic><topic>Consultation</topic><topic>Decision Making</topic><topic>doctor–patient communication</topic><topic>Domains</topic><topic>Drug dosages</topic><topic>Drugs</topic><topic>Empowerment</topic><topic>Group decision making</topic><topic>Health care</topic><topic>Health services</topic><topic>Humans</topic><topic>Insight</topic><topic>Knowledge</topic><topic>Medical research</topic><topic>Mental disorders</topic><topic>Mental Disorders - drug therapy</topic><topic>Mental health</topic><topic>Mental health care</topic><topic>Mental health services</topic><topic>Patient compliance</topic><topic>patient involvement</topic><topic>Patient Participation</topic><topic>Patient satisfaction</topic><topic>Prescribing</topic><topic>Prescription writing</topic><topic>Primary care</topic><topic>Professional-Patient Relations</topic><topic>psychiatric medication</topic><topic>psychiatry</topic><topic>Psychotropic drugs</topic><topic>Recovery</topic><topic>Review</topic><topic>Selfmanagement</topic><topic>Shape recognition</topic><topic>shared decision making</topic><topic>Side effects</topic><topic>Social background</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morant, Nicola</creatorcontrib><creatorcontrib>Kaminskiy, Emma</creatorcontrib><creatorcontrib>Ramon, Shulamit</creatorcontrib><collection>Wiley_OA刊</collection><collection>Wiley-Blackwell Free Backfiles(OpenAccess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health expectations : an international journal of public participation in health care and health policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morant, Nicola</au><au>Kaminskiy, Emma</au><au>Ramon, Shulamit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Shared decision making for psychiatric medication management: beyond the micro‐social</atitle><jtitle>Health expectations : an international journal of public participation in health care and health policy</jtitle><addtitle>Health Expect</addtitle><date>2016-10</date><risdate>2016</risdate><volume>19</volume><issue>5</issue><spage>1002</spage><epage>1014</epage><pages>1002-1014</pages><issn>1369-6513</issn><eissn>1369-7625</eissn><abstract>Background
Mental health care has lagged behind other health‐care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self‐management and recovery‐oriented practice, and growing policy‐level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals' needs.
Objectives
This conceptual review argues that several aspects of mental health care that differ from other health‐care contexts (e.g. forms of coercion, questions about service users' insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health‐care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro‐social focus of a medical consultation. Contextualizing specific medication‐related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM.
Conclusion
A broad conceptualization of decision making for psychiatric medication that moves beyond the micro‐social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>26260361</pmid><doi>10.1111/hex.12392</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-4022-8133</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Analysis Clinical decision making Clinical medicine Coercion Collaboration Consultation Decision Making doctor–patient communication Domains Drug dosages Drugs Empowerment Group decision making Health care Health services Humans Insight Knowledge Medical research Mental disorders Mental Disorders - drug therapy Mental health Mental health care Mental health services Patient compliance patient involvement Patient Participation Patient satisfaction Prescribing Prescription writing Primary care Professional-Patient Relations psychiatric medication psychiatry Psychotropic drugs Recovery Review Selfmanagement Shape recognition shared decision making Side effects Social background Systematic review |
title | Shared decision making for psychiatric medication management: beyond the micro‐social |
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