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

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Shared 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.

Focus 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).

Twenty-three patients participated in the study. Thematic analysis revealed that ‘side-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’. A decision aid was developed and is included in the supplementary information.

Patients 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.
Original languageEnglish
JournalBMC Psychiatry
Early online date23 Oct 2019
Publication statusE-pub ahead of print - 23 Oct 2019


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