Udskriv Udskriv
Switch language
Region Hovedstadens Psykiatri - en del af Københavns Universitetshospital

Digital Shared Decision-Making Interventions in Mental Healthcare: A Systematic Review and Meta-Analysis

Publikation: Bidrag til tidsskriftReviewForskningpeer review


  1. Anomalies of Imagination, Self-Disorders, and Schizophrenia Spectrum Psychopathology: A Network Analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Help-seekers in an Early Detection of Psychosis Service: the non-cases

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Mood and Activity Measured Using Smartphones in Unipolar Depressive Disorder

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Assessment of Suicide Risks During the First Week Immediately After Discharge From Psychiatric Inpatient Facility

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Background: Shared decision-making (SDM) in mental healthcare has received increased attention as a process to reinforce person-centered care. With the rapid development of digital health technology, researchers investigate how digital interventions may be utilized to support SDM. Despite the promise of digital interventions to support SDM, the effect of these in mental healthcare has not been evaluated before. Thus, this paper aims to assess the effect of SDM interventions complimented by digital technology in mental healthcare. Objective: The objective of this review was to systematically examine the effectiveness of digital SDM interventions on patient outcomes as investigated in randomized trials. Methods: We performed a systematic review and meta-analysis of randomized controlled trials on digital SDM interventions for people with a mental health condition. We searched for relevant studies in MEDLINE, PsycINFO, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials. The search strategy included terms relating to SDM, digital systems, mental health conditions, and study type. The primary outcome was patient activation or indices of the same (e.g., empowerment and self-efficacy), adherence to treatment, hospital admissions, severity of symptoms, and level of functioning. Secondary outcomes were satisfaction, decisional conflict, working alliance, usage, and adherence of medicine; and adverse events were defined as harms or side effects. Results: Sixteen studies met the inclusion criteria with outcome data from 2,400 participants. Digital SDM interventions had a moderate positive effect as compared with a control condition on patient activation [standardized mean difference (SMD) = 0.56, CI: 0.10, 1.01, p = 0.02], a small effect on general symptoms (SMD = −0.17, CI: −0.31, −0.03, p = 0.02), and working alliance (SMD = 0.21, CI: 0.02, 0.41, p = 0.03) and for improving decisional conflict (SMD = −0.37, CI: −0.70, −0.05, p = 0.02). No effect was found on self-efficacy, other types of mental health symptoms, adverse events, or patient satisfaction. A total of 39 outcomes were narratively synthesized with results either favoring the intervention group or showing no significant differences between groups. Studies were generally assessed to have unclear or high risk of bias, and outcomes had a Grading of Recommendations Assessment, Development and Evaluation (GRADE) rating of low- or very low-quality evidence. Conclusions: Digital interventions to support SDM may be a promising tool in mental healthcare; but with the limited quality of research, we have little confidence in the estimates of effect. More quality research is needed to further assess the effectiveness of digital means to support SDM but also to determine which digital intervention features are most effective to support SDM. Systematic Review Registration: PROSPERO, identifier CRD42020148132.

TidsskriftFrontiers in Psychiatry
StatusUdgivet - 6 sep. 2021

Bibliografisk note

Funding Information:
We would like to thank TrygFonden for making the study possible (Grant number: 115441). TrygFonden is a non-profit foundation, and its core areas include safety, health, and well-being.

Publisher Copyright:
© Copyright © 2021 Vitger, Korsbek, Austin, Petersen, Nordentoft and Hjorthøj.

ID: 67998803