Home > Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature.

Friedrichs, Anke and Spies, Maren and Härter, Martin and Buchholz, Angela [PLOS One] . (2016) Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature. Public Library of Science. PLoS ONE, 11 (1) /10.1371/journal.pone.0145817

URL: http://journals.plos.org/plosone/article?id=10.137...

BACKGROUND: Shared Decision Making (SDM) as means to the involvement of patients in medical decision making is increasingly demanded by treatment guidelines and legislation. Also, matching of patients' preferences to treatments has been shown to be effective regarding symptom reduction. Despite promising results for patients with substance use disorders (SUD) no systematic evaluation of the literature has been provided. The aim is therefore to give a systematic overview of the literature of patient preferences and SDM in the treatment of patients with SUD.

METHODS: An electronic literature search of the databases Medline, Embase, Psyndex and Clinical Trials Register was performed. Variations of the search terms substance use disorders, patient preferences and SDM were used. For data synthesis the populations, interventions and outcomes were summarized and described according to the PRISMA statement. Methodological quality of the included articles was assessed with the Mixed Methods Appraisal Tool.

RESULTS: N = 25 trials were included in this review. These were conducted between 1986 and 2014 with altogether n = 8.729 patients. Two studies found that patients with SUD preferred to be actively involved in treatment decisions. Treatment preferences were assessed in n = 18 studies, where the majority of patients preferred outpatient compared with inpatient treatment. Matching patients to preferences resulted in a reduction on substance use (n = 3 studies), but the majority of studies found no significant effect. Interventions for SDM differed across patient populations and optional therapeutic techniques.

DISCUSSION: Patients with substance use disorders should be involved in medical treatment decisions, as patients with other health conditions. A suitable approach is Shared Decision Making, emphasizing the patients' preferences. However, due to the heterogeneity of the included studies, results should be interpreted with caution. Further research is needed regarding SDM interventions in patient populations with substance use disorders.

 

[See also article in Drug and Alcohol Findings, 27 September 2016, http://findings.org.uk/PHP/dl.php?file=Friedrichs_A_1.txt&s=]

Item Type:Evidence resource
Drug Type:Alcohol or other drugs in general
Intervention Type:AOD disorder, AOD disorder drug therapy, AOD disorder treatment method, Education and training
Source:PLOS One
Date:2016
Page Range:e0145817
Publisher:Public Library of Science
Volume:11
Number:1
EndNote:View
Subjects:HJ Treatment method > Treatment outcome
J Health care, prevention and rehabilitation > Patient care management
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
J Health care, prevention and rehabilitation > Treatment and maintenance > Patient attitude toward treatment
J Health care, prevention and rehabilitation > Treatment and maintenance > Provider attitude toward treatment

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