Shared decision-making interventions in the choice of antipsychotic prescription in people living with psychosis (SHAPE): Protocol for a realist review

Ita Fitzgerald*, Laura J. Sahm, Jo Howe, Ian Maidment, Emma Wallace, Erin K. Crowley, Eleni Petkari (Editor)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Shared decision-making (SDM) has yet to be successfully adopted into routine use in psychiatric settings amongst people living with severe mental illnesses. Suboptimal rates of SDM are particularly prominent amongst patients with psychotic illnesses during antipsychotic treatment choices. Many interventions have been assessed for their efficacy in improving SDM within this context, although results have been variable and inconsistent. Aims: To generate an in-depth understanding of how, why, for whom, and to what extent interventions facilitating the application of SDM during antipsychotic treatment choices work and the impact of contextual factors on intervention effectiveness. Methods: This review will use realist review methodology to provide a causal understanding of how and why interventions work when implementing SDM during antipsychotic treatment choices. The cohort of interest will be those experiencing psychosis where ongoing treatment with an antipsychotic is clinically indicated. The review will take place over five stages; (1) Locating existing theories, (2) Searching for evidence, (3) Selecting articles, (4) Extracting and organising data and (5) Synthesizing evidence and drawing conclusions. An understanding of how and why interventions work will be achieved by developing realist programme theories on intervention effectiveness through iterative literature reviews and engaging with various stakeholder groups, including patient, clinician and carer representatives. Discussion: This is the first realist review aiming to identify generative mechanisms explaining how and why successful interventions aimed at improving SDM within the parameters outlined work and in which contexts desired outcomes are most likely to be achieved. Review findings will include suggestions for clinicians, policy and decision-makers about the most promising interventions to pursue and their ideal attributes.
Original languageEnglish
Article numbere0304626
Number of pages13
JournalPLoS ONE
Volume19
Issue number7
Early online date25 Jul 2024
DOIs
Publication statusPublished - Jul 2024

Bibliographical note

Copyright: © 2024 Fitzgerald et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Access Statement

No results are reported - this is a protocol paper. Data availability statement not required.

Keywords

  • Antipsychotic Agents/therapeutic use
  • Choice Behavior
  • Decision Making, Shared
  • Humans
  • Patient Participation
  • Psychotic Disorders/drug therapy

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