Evidence map›Paper›PMID 31646985›Full record

ArticleBMC psychiatry2019

Making decisions about antipsychotics: a qualitative study of patient experience and the development of a decision aid.

S J Kaar, C Gobjila, E Butler, C Henderson, O D Howes

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In one paragraph

Article in BMC psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

S J KaarDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, PO63 De Crespigny Park, London, SE5 8AF, UK. stephen.kaar@kcl.ac.uk.
C GobjilaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, PO63 De Crespigny Park, London, SE5 8AF, UK.
E ButlerDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, PO63 De Crespigny Park, London, SE5 8AF, UK.
C HendersonHealth Service and Population Research, Psychological and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AZ, UK.
O D HowesDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, PO63 De Crespigny Park, London, SE5 8AF, UK.

Funding

Medical Research Council MR/L022176/1Medical Research Council MR/N027078/1
6 · The paper itself

Abstract

backgroundShared decision making is a widely accepted standard of patient-centred care that leads to improved clinical outcomes, yet it is commonly underutilised in the field of mental health. Furthermore, little is known regarding patient decision making around antipsychotic medication, which is often poorly adhered to. We aim to explore psychiatric patients' experiences of antipsychotic medication decision making in order to develop a patient decision aid to promote shared decision making.

methodsFocus groups were conducted with patients with chronic psychotic illnesses (n = 20) who had previously made a decision about taking or changing antipsychotic medication. Transcripts were coded and analysed for thematic content and continued until thematic saturation. These themes subsequently informed the development of a decision aid with the help of expert guidance. Further patient input was sought using the think aloud method (n = 3).

resultsTwenty-three patients participated in the study. Thematic analysis revealed that 'adverse effects' was the most common theme identified by patients surrounding antipsychotic medication decision-making followed by 'mode and time of administration', 'symptom control' and 'autonomy'. The final decision aid is included to provoke further discussion and development of such aids.

conclusionsPatients commonly report negative experiences of antipsychotic medication, in particular side-effects, which remain critical to future decision making around antipsychotic medication. Clinical encounters that increase patient knowledge and maximise autonomy in order to prevent early negative experiences with antipsychotic medication are likely to be beneficial.

Indexed as

Decision MakingDecision Support TechniquesAdultAntipsychotic AgentsChronic DiseaseFemaleFocus GroupsHumansMaleMental DisordersPatient ParticipationQualitative ResearchAntipsychotic AgentsAdverse effectsAntipsychoticInformed consentPatient preferenceShared decision making

Identifiers

PMID31646985
PMCPMC6806500

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.