Psychiatric patients' attitudes towards concordance and shared decision making

Objectives: To assess psychiatric outpatients' attitudes towards concordance and shared decision making in a psychiatric setting and to evaluate the role that self-perceived knowledge and beliefs about psychiatric medicines play in those attitudes. Methods: The Leeds Attitude to Concordance Scale (LATCon) was tested on a sample of 435 psychiatric outpatients. Principal Component Analysis was used to assess the structure of LATCon items. Regression analysis on LATCon scores was performed with sociodemographics, Belief about Medicines Questionnaire (BMQ) subscales, self-perceived knowledge, perceived psychiatrist behaviour and current medications as predictor variables. Results: The LATCon scale showed a good factorial validity, with a monofactorial structure and high internal consistency. Psychiatric outpatients tended to be in agreement with the concept of concordance, but they did not share some relevant aspects of the construct. Cognitive representations of psychiatric medications, assessed by the BMQ subscales, significantly predicted scores on the LATCon scale. Conclusion: Psychiatric outpatients show a considerable desire to participate in decision making about their treatment. The Spanish version of the LATCon Scale seems to be a valid instrument. Practice implications: Psychiatrists must consider their patients' desire to participate in treatment decisions and explore how patients' views about psychiatric medications influence their attitudes towards concordance. (C) 2011 Elsevier Ireland Ltd. All rights reserved.