Community Mental Health Journal

, Volume 49, Issue 2, pp 185–192 | Cite as

Use of a Computerized Medication Shared Decision Making Tool in Community Mental Health Settings: Impact on Psychotropic Medication Adherence

  • Bradley D. Stein
  • Jane N. Kogan
  • Mark J. Mihalyo
  • James Schuster
  • Patricia E. Deegan
  • Mark J. Sorbero
  • Robert E. Drake
Original Paper


Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.


Psychotropic medication Medication adherence Shared-decision making Computer intervention Recovery 



This research was funded by Community Care Behavioral Health Organization and the West Foundation. The authors would like to thank Laura Greenberg and Amanda Ayers for assistance in manuscript preparation.

Conflict of interest

Dr. Deegan is the owner of the CommonGround software program. The remaining authors have no interests to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Bradley D. Stein
    • 1
  • Jane N. Kogan
    • 2
  • Mark J. Mihalyo
    • 3
  • James Schuster
    • 3
  • Patricia E. Deegan
    • 4
  • Mark J. Sorbero
    • 3
  • Robert E. Drake
    • 5
  1. 1.RAND CorporationPittsburghUSA
  2. 2.UPMC Center for High Value Health CarePittsburghUSA
  3. 3.Community Care Behavioral Health OrganizationOne Chatham CenterPittsburghUSA
  4. 4.ByfieldUSA
  5. 5.Dartmouth Psychiatric Research CenterRivermill Commercial CenterLebanonUSA

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