Exploring service users', carers' and professionals' perspectives and experiences of current antipsychotic prescribing: A qualitative study. (December 2017)

• Record Type: Journal Article
• Authors: Harris, Kamelia; Brooks, Helen; Lythgoe, Garry; Bee, Penny; Lovell, Karina; Drake, Richard J
• Is Part Of: Chronic illness. Volume 13:Number 4(2017:Dec.)
• Page Start: 275
• Page End: 287
• Publication Date: 2017-12
• Subjects: Shared decision-making -- antipsychotic prescribing -- collaborative prescribing -- service user -- carer; Chronic diseases -- Periodicals; 616.04405
• DOI: 10.1177/1742395317694223
• Languages: English
• ISSNs: 1742-3953

Abstract

Objectives: Shared decision-making is the pinnacle of patient-centred care; mental health stakeholders value shared decision-making but find it difficult to enact. The objective was to compare and synthesise mental health stakeholder views on antipsychotic prescribing in one NHS Trust, to understand potential reasons for the difficult enactment of shared decision-making in practice. Methods: We conducted 12 interviews and 5 focus groups with 33 mental health stakeholders, after obtaining their informed consent. They shared their experiences in and perceptions of antipsychotic prescribing and were recruited from Manchester Mental Health and Social Care Trust. Results: Stakeholders agreed that successful shared decision-making demands a collaborative approach. We elucidated a striking divergence in views of the decision-making process and understanding of collaboration. Nurses, consultants and the pharmacist seemed most satisfied with the amount of collaboration but most pessimistic about the scope for it. Carers and most service users did not feel that there was any collaboration. Discussion: Comparison of perspectives demonstrated the complexity of shared decision-making which is not addressed in current operational definitions or policy or nursing practice initiatives. The findings have the potential to progress initiatives in the mental health field from those that emphasise the need for shared decision-making to those that develop tools to promote shared decision-making.