Client preferences affect treatment satisfaction,completion, and clinical outcome: A meta-analysis |
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| Affiliation: | 1. University of Pittsburgh, United States;2. University of Pittsburgh Medical Center, United States;3. Wayne State University, United States;1. Vanderbilt Institute for Clinical Translational Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA;2. GeneDx, Inc, Gaithersburg, MD 20877, USA;3. Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA;4. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA;5. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA;6. Department of Radiology, Meharry Medical College, Nashville, TN 37208, USA;2. University of Koblenz–Landau, Landau, Germany;3. Philipps-University Marburg, Marburg, Germany;1. Saint Louis University, Department of Psychology;2. University of North Carolina at Chapel Hill, Department of Physical Medicine and Rehabilitation;1. Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, OR, United States;2. Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, United States |
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| Abstract: | We conducted a meta-analysis on the effects of client preferences on treatment satisfaction, completion, and clinical outcome. Our search of the literature resulted in 34 empirical articles describing 32 unique clinical trials that either randomized some clients to an active choice condition (shared decision making condition or choice of treatment) or assessed client preferences. Clients who were involved in shared decision making, chose a treatment condition, or otherwise received their preferred treatment evidenced higher treatment satisfaction (ESd = .34; p < .001), increased completion rates (ESOR = 1.37; ESd = .17; p < .001), and superior clinical outcome (ESd = .15; p < .0001), compared to clients who were not involved in shared decision making, did not choose a treatment condition, or otherwise did not receive their preferred treatment. Although the effect sizes are modest in magnitude, they were generally consistent across several potential moderating variables including study design (preference versus active choice), psychoeducation (informed versus uninformed), setting (inpatient versus outpatient), client diagnosis (mental health versus other), and unit of randomization (client versus provider). Our findings highlight the clinical benefit of assessing client preferences, providing treatment choices when two or more efficacious options are available, and involving clients in treatment-related decisions when treatment options are not available. |
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