Het effect van samen beslissen bij depressie: systematische review en meta-analyse

BACKGROUND: Shared decision making (SDM) is advised in the treatment guideline for depressive disorders. However, it’s unclear if SDM contributes to the optimization of care. AIM: To provide an overview of the effects of SDM within the treatment of depression on treatment outcome, patient satisfaction and adherence through a meta-analysis and systematic review. METHOD: In a literature search (PubMed, PsycINFO, Embase), randomised controlled studies with patients who suffer from depression or depressive symptoms were selected. The effect of a SDM intervention previous to treatment was compared to no SDM intervention on the outcome measures. Effect sizes were computed with random effects models and risk of bias was assessed. RESULTS: Five studies were included (N = 850). SDM did not result in superior treatment outcome (Cohen’s d = 0.02;
95%-BI:-0.12-0,16; p = 0.773) and adherence (Cohen’s d = 0.29; 95%-BI:-0.01-0.58; p = 0.056). SDM did lead to higher patient satisfaction with a medium-large effect size (Cohen’s d = 0.53; 95%-BI:0,17-0.90; p = .004). CONCLUSION: SDM resulted in higher patient satisfaction, no effects were found regarding treatment outcome and adherence. However, operationalisation of SDM in the studies were variable. SDM appears to be a versatile construct in clinical practice.