Trial reportPloS one2018
Embedding shared decision-making in the care of patients with severe and enduring mental health problems: The EQUIP pragmatic cluster randomised trial.
Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 10 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Effects of psychosocial interventions on wellbeing in individuals with severe mental illness: a systematic review.Frontiers in psychology · 2025Pooled it
- Supported Decision-Making Interventions in Mental Healthcare: A Systematic Review of Evidence on the Outcomes for People With Mental Ill Health.Health expectations : an international journal of public participation in health care and health policy · 2024Pooled it
- Collaborative care approaches for people with severe mental illness.The Cochrane database of systematic reviews · 2024Pooled it
- Supported decision-making interventions in mental healthcare: A systematic review of current evidence and implementation barriers.Health expectations : an international journal of public participation in health care and health policy · 2024Pooled it
- Shifting Perspectives on the Challenges of Shared Decision Making in Mental Health Care.Community mental health journal · 2024Pooled it
- What Works to Improve Wellbeing? A Rapid Systematic Review of 223 Interventions Evaluated with the Warwick-Edinburgh Mental Well-Being Scales.International journal of environmental research and public health · 2022Pooled it
- Shared decision-making interventions for people with mental health conditions.The Cochrane database of systematic reviews · 2022Pooled it
- Mental health professionals' perceived barriers and enablers to shared decision-making in risk assessment and risk management: a qualitative systematic review.BMC psychiatry · 2021Pooled it
- A Systematic Review of Shared Decision-Making Interventions for Service Users With Serious Mental Illnesses: State of the Science and Future Directions.Psychiatric services (Washington, D.C.) · 2021Pooled it
- Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation.The Cochrane database of systematic reviews · 2021Pooled it
- Implementing an intervention designed to enhance service user involvement in mental health care planning: a qualitative process evaluation.Social psychiatry and psychiatric epidemiology · 2019Trial
- Trial
- Bridging the Gap Between Efficacy and Practice: A Systematic Review of Shared Decision-Making in Severe Mental Illness.Journal of multidisciplinary healthcare · 2026Review
- Development and acceptability of a decision aid for anxiety disorder considering discontinuation of benzodiazepine anxiolytic.Frontiers in psychiatry · 2023Article
- Development and acceptability of a decision aid for chronic insomnia considering discontinuation of benzodiazepine hypnotics.Neuropsychopharmacology reports · 2022Review
- Article
- What does safety in mental healthcare transitions mean for service users and other stakeholder groups: An open-ended questionnaire study.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Shared decision making for adults with severe mental illness: A concept analysis.Japan journal of nursing science : JJNS · 2020Review
- Article
- Psychiatric Advance Directives and their relevance to improving psychiatric care in Asian countries.Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundSevere mental illness is a major driver of worldwide disease burden. Shared decision-making is critical for high quality care, and can enhance patient satisfaction and outcomes. However, it has not been translated into routine practice. This reflects a lack of evidence on the best way to implement shared decision-making, and the challenges of implementation in routine settings with limited resources. Our aim was to test whether we could deliver a practical and feasible intervention in routine community mental health services to embed shared decision-making for patients with severe mental illness, by improving patient and carer involvement in care planning.
methodsWe cluster randomised community mental health teams to the training intervention or usual care, to avoid contamination. Training was co-delivered to a total of 350 staff in 18 teams by clinical academics, working alongside patients and carers. The primary outcome was the Health Care Climate Questionnaire, a self-report measure of 'autonomy support'. Primary and secondary outcomes were collected by self-report, six months after allocation.
findingsIn total, 604 patients and 90 carers were recruited to main trial cohort. Retention at six months was 82% (n = 497). In the main analysis, results showed no statistically significant difference in the primary outcome between the intervention and usual care at 6 months (adjusted mean difference -0.064, 95% CI -0.343 to 0.215, p = 0.654). We found significant effects on only 1 secondary outcome.
conclusionsAn intervention to embed shared decision-making in routine practice by improving involvement in care planning was well attended and acceptable to staff, but had no significant effects on patient outcomes. Enhancing shared decision-making may require considerably greater investment of resources and effects may only be apparent over the longer term.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.