Shared decision-making preferences in mental health: does age matter? A systematic review

Abstract

Background

Research to date suggests older adults prefer a passive involvement in the clinical decision-making process; however, the empirical evidence underlying this claim in the mental health context is yet to be reviewed systematically.

Aims

To understand whether older adults desire involvement in mental health-related clinical decisions.

Method

A systematic review was conducted to identify primary research that explored mental-health decision-making preferences of people with a mean age of over 55 from January 1990 through to December 2018.

Results

Three independent studies of varying design and quality were included. Study settings were in the USA, Germany, and the UK. A preference for shared decision-making was seen in two studies, while a preference for active decision-making was identified in one.

Conclusions

In contrast to other reviews on clinical decision-making, this review focused on mental health-related decisions of older adults. The evidence suggests older adults desire involvement in mental health-related clinical decisions. Given the political drive to empower patients and the need to ensure evidence-based clinical practice, more high-quality research regarding the shared decision-making preferences and outcomes of older adults with mental ill-health is needed.

Systematic Review Registration PROSPERO: CRD42018102009

Keywords:

• Shared decision-making
• mental health
• age
• older adults
• clinical decision-making

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Economic and Social Research Council (ESRC) Wales Doctoral Training Partnership: Data Science, Health and Wellbeing Studentship under Grant [ES/P00069X/1] (LB). The funders had no role in study design, data collection, analysis, decision to publish or preparation of the manuscript.