Enhancing patient-clinician collaboration during treatment decision-making: study protocol for a community-engaged, mixed method hybrid type 1 trial of collaborative decision skills training (CDST) for veterans with psychosis

Emily B H Treichler; Lauren E McBride; Elissa Gomez; Joanna Jain; Sydney Seaton; Kasey E Yu; David Oakes; Dimitri Perivoliotis; Vanessa Girard; Samantha Reznik; Michelle P Salyers; Michael L Thomas; William D Spaulding; Eric L Granholm; Borsika A Rabin; Gregory A Light

doi:10.1186/s13063-024-08127-4

Enhancing patient-clinician collaboration during treatment decision-making: study protocol for a community-engaged, mixed method hybrid type 1 trial of collaborative decision skills training (CDST) for veterans with psychosis

Trials. 2024 Jun 6;25(1):363. doi: 10.1186/s13063-024-08127-4.

Authors

Emily B H Treichler^{1

2

3}, Lauren E McBride^{4

5}, Elissa Gomez^{4

6}, Joanna Jain^{4

6}, Sydney Seaton^{4

6}, Kasey E Yu^{4

6}, David Oakes⁴, Dimitri Perivoliotis^{5

7}, Vanessa Girard⁷, Samantha Reznik⁸, Michelle P Salyers⁹, Michael L Thomas¹⁰, William D Spaulding¹¹, Eric L Granholm^{5

7}, Borsika A Rabin^{12

6

13}, Gregory A Light^{4

5}

Affiliations

¹ VA Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA, USA. [email protected].
² Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA. [email protected].
³ UC San Diego Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA. [email protected].
⁴ VA Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA, USA.
⁵ Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0804, La Jolla, CA, 92093, USA.
⁶ Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA.
⁷ VA San Diego Psychology Service, San Diego, CA, USA.
⁸ University of Texas at Austin, Texas Institute for Excellence in Mental Health, Austin, USA.
⁹ Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, IN, USA.
¹⁰ Department of Psychology, Colorado State University, Fort Collins, CO, USA.
¹¹ Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA.
¹² UC San Diego Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA.
¹³ Center of Excellence in Stress and Mental Health, San Diego VA, La Jolla, CA, USA.

Abstract

Background: Patient participation in treatment decision making is a pillar of recovery-oriented care and is associated with improvements in empowerment and well-being. Although demand for increased involvement in treatment decision-making is high among veterans with serious mental illness, rates of involvement are low. Collaborative decision skills training (CDST) is a recovery-oriented, skills-based intervention designed to support meaningful patient participation in treatment decision making. An open trial among veterans with psychosis supported CDST's feasibility and demonstrated preliminary indications of effectiveness. A randomized control trial (RCT) is needed to test CDST's effectiveness in comparison with an active control and further evaluate implementation feasibility.

Methods: The planned RCT is a hybrid type 1 trial, which will use mixed methods to systematically evaluate the effectiveness and implementation feasibility of CDST among veterans participating in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) in Southern California. The first aim is to assess the effectiveness of CDST in comparison with the active control via the primary outcome, collaborative decision-making behavior during usual care appointments between veterans and their VA mental health clinicians, and secondary outcomes (i.e., treatment engagement, satisfaction, and outcome). The second aim is to characterize the implementation feasibility of CDST within the VA PRRC using the Practical Robust Implementation and Sustainability Model framework, including barriers and facilitators within the PRRC context to support future implementation.

Discussion: If CDST is found to be effective and feasible, implementation determinants gathered throughout the study can be used to ensure sustained and successful implementation at this PRRC and other PRRCs and similar settings nationally.

Trial registration: ClinicalTrials.gov NCT04324944. Registered on March 27, 2020. Trial registration data can be found in Appendix 1.

Keywords: Implementation science; Person-centered care; Recovery; Schizophrenia; Shared decision-making.

Publication types

Clinical Trial Protocol

MeSH terms

California
Clinical Decision-Making
Cooperative Behavior
Decision Making
Decision Making, Shared
Feasibility Studies
Humans
Patient Participation*
Physician-Patient Relations
Psychotic Disorders* / psychology
Psychotic Disorders* / therapy
Randomized Controlled Trials as Topic*
United States
United States Department of Veterans Affairs
Veterans* / psychology

Associated data

ClinicalTrials.gov/NCT04324944

Grants and funding

1IK2RX00307901A2/Rehabilitation Research and Development Service