Open Access Research article

Attitudes toward concordance in psychiatry: a comparative, cross-sectional study of psychiatric patients and mental health professionals

Carlos De las Cuevas12*, Amado Rivero-Santana3, Lilisbeth Perestelo-Pérez24, Jeanette Pérez-Ramos3 and Pedro Serrano-Aguilar24

Author Affiliations

1 University of La Laguna, Faculty of Medicine, Campus de Ofra s/n, San Cristóbal de La Laguna, Canary Islands 38071, Spain

2 CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

3 Fundación Canaria de Investigación en Salud (FUNCIS), Santa Cruz de Tenerife, Spain

4 Health Technology Assessment Unit, Canary Islands Health Service, Government of the Canary Islands, Pérez de Rozas 5, 4th floor, Santa Cruz de Tenerife, Canary Islands 38004, Spain

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BMC Psychiatry 2012, 12:53  doi:10.1186/1471-244X-12-53

Published: 30 May 2012

Abstract

Background

Concordance and Shared Decision-Making (SDM) are considered measures of the quality of care that improves communication, promotes patient participation, creates a positive relationship with the healthcare professional, and results in greater adherence with the treatment plan.

Methods

This study compares the attitudes of 225 mental health professionals (125 psychiatrists and 100 psychiatry registrars) and 449 psychiatric outpatients towards SDM and concordance in medicine taking by using the "Leeds Attitude toward Concordance Scale" (LATCon).

Results

The internal consistency of the scale was good in all three samples (Cronbach's α: patients = 0.82, psychiatrists = 0.76, and registrars = 0.82). Patients scored significantly lower (1.96 ± 0.48) than professionals (P < .001 in both cases), while no statistically significant differences between psychiatrists (2.32 ± 0.32) and registrars (2.23 ± 0.35) were registered; the three groups showed a positive attitude towards concordance in most indicators. Patients are clearly in favor of being informed and that their views and preferences be taken into account during the decision-making process, although they widely consider that the final decision must be the doctor's responsibility. Among mental health professionals, the broader experience provides a greater conviction of the importance of the patient's decision about treatment.

Conclusions

We observed a positive attitude towards concordance in the field of psychotropic drugs prescription both in professionals and among patients, but further studies are needed to address the extent to which this apparently accepted model is reflected in the daily practice of mental health professionals.

Keywords:
Attitudes; Concordance; LATCon; Psychiatric outpatients; Psychiatrist; Psychiatry registrar; Shared decision-making