Although effective treatment for schizophrenia requires sustained involvement in care, treatment drop-out and non-adherence are common. The literature suggests that sustained involvement may increase when stakeholders agree on treatment goals. This study assessed (1) agreement on outcome priorities and treatment preferences within stakeholder sets, (2) provider and family-member awareness of consumer priorities and preferences, and (3) the association between agreement and involvement in care.
Rank-order and magnitude-estimation data on priorities and preferences were collected through interviews with stakeholder sets (a consumer with schizophrenia, a member of the consumer's family, and the consumer's mental healthcare provider).
Regardless of the measure used, within-set agreement on outcome priorities was limited. Agreement on rank ordering was highest between consumers and family members (36% of pairs), followed by family members and providers (24%), and consumers and providers (20%). Agreement among all 3 within-set pairs was observed in only 8% of sets, while no pairs were in agreement for 48% of sets. Providers appeared more knowledgeable than family members regarding consumer outcome priorities. Agreement on treatment preferences was greater: family-provider pairs (58%), consumer-family (42%), consumer-provider (33%). Results will be presented on the association between agreement and involvement in care.
The preferences literature in schizophrenia emphasizes agreement between groups of stakeholders, rather than within stakeholder sets. The limited agreement and awareness we observed among "working partners" (stakeholder sets) suggests that interventions to increase agreement on goals may offer a promising strategy for motivating consumers to remain in treatment over time, reducing the efficacy-effectiveness gap in schizophrenia care.
Learning Objectives: At the conclusion of this presentation, the participant will be able to: (1) Describe the nature and extent of agreement on the goals of schizophrenia treatment within sets of related stakeholders, (2) Discuss the impact of within-set agreement on sustained consumer involvement in care for schizophrenia, and (3) Compare the merits of 3 approaches for quantifying within-set agreement
Keywords: Sever Mental Illness, Quality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.