title: Choice of antipsychotic treatment by European psychiatry trainees: are decisions based on evidence?
abstract: BACKGROUND
  Little is known about the factors influencing treatment choice in psychosis, the majority of this work being conducted with specialists (consultant) in psychiatry. We sought to examine trainees' choices of treatment for psychosis if they had to prescribe it for themselves, their patients, and factors influencing decision-making.
  
  
  METHODS
  Cross-sectional, semi-structured questionnaire-based study.
  
  
  RESULTS
  Of the 726 respondents (response rate = 66%), the majority chose second-generation antipsychotics (SGAs) if they had to prescribe it for themselves (n = 530, 93%) or for their patients (n = 546, 94%). The main factor influencing choice was perceived efficacy, 84.8% (n = 475) of trainees stating this was the most important factor for the patient, and 77.8% (n = 404) stating this was the most important factor for their own treatment. Trainees with knowledge of trials questioning use of SGAs (CATIE, CUtLASS, TEOSS) were more likely to choose second-generation antipsychotics than those without knowledge of these trials (χ2 = 3.943; p = 0.047; O.R. = 2.11; 95% C.I. = 1.0-4.48). Regarding psychotherapy, cognitive behavioural therapy (CBT) was the most popular choice for self (33.1%; n = 240) and patient (30.9%; n = 224). Trainees were significantly more likely to prefer some form of psychotherapy for themselves rather than patients (χ2 = 9.98; p < 0,002; O.R. = 1.54; 95% CIs = 1.18-2.0).
  
  
  CONCLUSIONS
  Trainees are more likely to choose second-generation antipsychotic medication for patients and themselves. Despite being aware of evidence that suggests otherwise, they predominantly base these choices on perceived efficacy.
authors.affiliation: EFPT Research Group, Sackler Institute for Psychobiological Research, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Rd, Glasgow, UK. sameerjauhar@gmail.com
authors.forename: Sameer
authors.initials: S
authors.lastname: Jauhar
authors.forename: Sinan
authors.initials: S
authors.lastname: Guloksuz
authors.forename: Olivier
authors.initials: O
authors.lastname: Andlauer
authors.forename: Greg
authors.initials: G
authors.lastname: Lydall
authors.forename: João Gama
authors.initials: JG
authors.lastname: Marques
authors.forename: Luis
authors.initials: L
authors.lastname: Mendonca
authors.forename: Iolanda
authors.initials: I
authors.lastname: Dumitrescu
authors.forename: Costin
authors.initials: C
authors.lastname: Roventa
authors.forename: Nele
authors.initials: N
authors.lastname: De Vriendt
authors.forename: Jeroen
authors.initials: J
authors.lastname: Van Zanten
authors.forename: Florian
authors.initials: F
authors.lastname: Riese
authors.forename: Izu
authors.initials: I
authors.lastname: Nwachukwu
authors.forename: Alexander
authors.initials: A
authors.lastname: Nawka
authors.forename: Raphael
authors.initials: R
authors.lastname: Psaras
authors.forename: Neil
authors.initials: N
authors.lastname: Masson
authors.forename: Rajeev
authors.initials: R
authors.lastname: Krishnadas
authors.forename: Umberto
authors.initials: U
authors.lastname: Volpe
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D019317:Evidence-Based Medicine; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians'; D011570:Psychiatry / Q000193:education*; D011618:Psychotic Disorders / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D014150:Antipsychotic Agents