Lian Van Der Krieke*, PhD student, University Center for Psychiatry, University Medical Center Groningen, Groningen, Netherlands Ando C Emerencia, PhD student, Bernoulli Institute for Mathematics and Computer Science, University of Groningen, Groningen, Netherlands Lex Wunderink, MD, PhD, GGZ Friesland, Unversity Center for Psychiatry, University Medical Center Groningen, Leeuwarden, Netherlands Sjoerd Sytema*, PhD, University Center for Psychiatry, University Medical Center Groningen, Groningen, Netherlands Track: Research Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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Background:
Psychotic disorders are among the most severe and disabling mental disorders, characterized by abnormalities in the perception of reality and cognitive functioning. They generally lead to significant social and occupational dysfunction. The lifetime prevalence is estimated as 1% of the general population. Dutch mental health institutions provide a broad array of evidence based interventions for psychotic disorders (i.e. schizophrenia), and in the North of the Netherlands this has led to the development of specific disease management protocols. However, within such protocols the health care system is mainly driven by supply instead of by the needs of users. The delivery of care and the selection of specific interventions is insufficiently based on individual demands and needs, and it does not reflect a model of shared decision making.

Objective:
The aim of this study was to examine whether processes of shared decision making between patient and clinician in treatment planning can be supported by a web-based application. This web-based application provides patients information about their health care needs and treatment options and it encourages them to decide on their personal preferences.

Methods:
We conducted a randomized controlled trial among 200 outpatients with psychotic disorders. Patients in the intervention condition were provided the opportunity to use the web-based application, whereas patients in the control group received care as usual. The web-based application consisted of three parts: 1) a questionnaire measuring a patient’s care needs (based on items of the Camberwell Assessment of Need), 2) an overview of treatment options, including information about the clinicians involved and experiences of fellow patients, and 3) a part in which patients could indicate their personal preferences for treatment. At baseline, we measured demographics and patients’ preferences for participation in medical decision making with the subscale ‘decision making’ of the Autonomy Preference Index (API). Primary outcome measure was satisfaction with the treatment planning process.

Results:
All patients have been randomized and included in the study. No clinical and sociodemographic differences were found between patients in the intervention condition and patients in the control condition at baseline. Primary outcomes of the trial are expected in the next two months, and will be presented at the conference.

Conclusion:
Patients seem to be able to work with the web-based application and the majority of them is motivated to participate in medical decision making. Final conclusions will be discussed at the conference.