title: Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness.
abstract: Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user's lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.
authors.affiliation: Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
authors.forename: Mediha
authors.initials: M
authors.lastname: Younas
authors.affiliation: Institute of Health and Society, University of Worcester, Henwick Grove, Worcester, WR2 6AJ, UK.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Bradley
authors.affiliation: Forensic Services, Nottinghamshire Healthcare NHS Foundation Trust, Rampton Pharmacy, Rampton Hospital, Retford, Nottinghamshire, DN22 0PD, UK.
authors.forename: Nikki
authors.initials: N
authors.lastname: Holmes
authors.affiliation: Leicestershire Partnership NHS Trust, Glenfield Hospital, Leicester, LE3 9EJ, UK.
authors.forename: Dolly
authors.initials: D
authors.lastname: Sud
authors.affiliation: School of Life and Health Sciences, Medicines and Devices in Ageing Cluster Lead, Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Aston Triangle, Birmingham, B4 7ET, UK. i.maidment@aston.ac.uk.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Maidment
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D000066491:Clinical Decision-Making / Q000379:methods*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008603:Mental Health; D010595:Pharmacists; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic prescribing; Mental health pharmacy; Shared decision making; United Kingdom