How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic medication?

Read, John

doi:10.1080/09638237.2022.2069708

Cited by 5 publications

(4 citation statements)

References 64 publications

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“…[3][4][5] Yet, evidence demonstrates that progress in mental health services towards this objective, in practice, has lagged. 3,[6][7][8][9][10][11][12][13][14][15][16][17] Both shared decision-making and, more recently, supported decision-making, are models that can be applied in mental health treatment planning to facilitate opportunities for the greater involvement of service users in that experience. 18,19 Both sit along a spectrum of approaches to medical decision-making, between the still prevalent paternalistic model and the autonomous decision model.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there seems to be general in‐principle recognition by mental health practitioners of the importance of shared and supported decision‐making in the care that they provide 3–5 . Yet, evidence demonstrates that progress in mental health services towards this objective, in practice , has lagged 3,6–17 …”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 , 5 Yet, evidence demonstrates that progress in mental health services towards this objective, in practice , has lagged. 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

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Supported decision‐making interventions in mental healthcare: A systematic review of current evidence and implementation barriers

Francis,

Johnson,

Wilson

2024

Health Expectations

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BackgroundThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In‐principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice.ObjectivesWe conducted a systematic review of quantitative, qualitative and mixed‐method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation.MethodsSeven databases were searched and 5137 articles were screened. Articles were included if they reported on an intervention for adult service users, were published between 2008 and October 2023 and were in English. Evidence in the 140 included articles was synthesised according to the JBI guidance on Mixed Methods Systematic Reviews.ResultsResearch in this field remains exploratory in nature, with a wide range of interventions investigated to date but little experimental replication. Overarching barriers to shared and supported decision‐making in mental health treatment planning were (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health‐related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians).ConclusionsOn the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programs, the designing of new tools and for clinicians seeking to practice shared and supported decision‐making in the healthcare they offer.Patient or Public ContributionThis systematic review has been guided at all stages by a researcher with experience of mental health service use, who does not wish to be identified at this point in time. The findings may inform organisations, researchers and practitioners on implementing supported decision‐making, for the greater involvement of people with mental ill health in their healthcare.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Supported decision‐making interventions in mental healthcare: A systematic review of current evidence and implementation barriers

Francis,

Johnson,

Wilson

2024

Health Expectations

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“… 16 The prescribing process (i.e., information exchanged and uncertainties discussed) is a key variable in the overall outcome, especially among patients who face negative experiences when seeking care. 17 In the absence of reliable, person-specific indicators of an impending relapse, individualized plans of collaborative antipsychotic discontinuation are necessary for optimal early intervention for psychosis.…”

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confidence: 99%

Collaborative discontinuation of antipsychotics after the first episode of psychosis

Korchia,

Abdelhafez,

Bretelle

et al. 2023

jpn

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Strategies and Management for Psychiatric Drug Withdrawal: A Systematic Review of Case Reports and Series

Eserian,

Blanco,

Mercuri

et al. 2024

Pharmacopsychiatry

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In recent years, an increasing number of case reports on psychiatric drug withdrawal have emerged, offering detailed clinical insights and valuable real-world evidence on the withdrawal process. The objective of this review was to evaluate the strategies and management for withdrawing psychiatric drugs, as detailed in case reports and series. A systematic review of case reports and series published between 2013 and 2023 was conducted to capture the latest trends in psychiatric drug withdrawal. Cases were identified following the PRISMA guidelines by searching electronic databases Medline and Scopus. Finally, 47 case reports and series were included. The primary reason for drug withdrawal was attributed to the emergence of adverse events, followed by medication dependence or abuse, and clinical decision-making or symptom resolution. Gradual reduction of doses was implemented through various management approaches as the primary strategy for drug withdrawal, and drug substitution emerged as the second most employed strategy. Also, patients were mostly undergoing polypharmacy. Favorable treatment outcomes were reported in the majority of cases, suggesting that psychiatric drug withdrawal is feasible – though quite challenging in some situations. However, the remarkably low number of unsuccessful cases may create a misleading impression of the significant difficulty associated with withdrawing psychiatric drugs.

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How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic medication?

Abstract: How important are informed consent, informed choice, and patientdoctor relationships, when prescribing antipsychotic medication? Read, John

Cited by 5 publications

References 64 publications

Supported decision‐making interventions in mental healthcare: A systematic review of current evidence and implementation barriers

Supported decision‐making interventions in mental healthcare: A systematic review of current evidence and implementation barriers

Collaborative discontinuation of antipsychotics after the first episode of psychosis

Strategies and Management for Psychiatric Drug Withdrawal: A Systematic Review of Case Reports and Series

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