'I Wish It Were More Often Told to People Before They Are Prescribed These Medications How Hard It Is to Get Off Them': A Qualitative Descriptive Analysis of Free-Text Responses to a Survey on Reducing and Stopping Psychiatric Medication.

INTRODUCTION

Despite significant increases in the prescribing of psychiatric medication in recent years, many uncertainties exist regarding the process of reducing and stopping these medications. A James Lind Alliance Priority Setting Partnership (PSP) study was conducted to identify the top 10 research priorities on reducing and stopping psychiatric medication. As part of the PSP study, an online survey was conducted, which asked respondents to submit their views and experiences of reducing and/or stopping psychiatric medication as free-text comments. This study aimed to conduct a descriptive analysis on these free-text survey responses.

METHODS

A qualitative descriptive analysis was undertaken on responses submitted to the online survey, which was disseminated using social media, newsletters and emails. Responses were submitted by three stakeholder groups (i.e., people with lived experience of taking and/or stopping psychiatric medication, family members/carers/supporters and healthcare professionals). All survey responses were downloaded, screened and analysed using template analysis. A coding template was iteratively developed using samples of responses and then applied to the responses by the researchers working independently.

RESULTS

In total, 705 responses contained free-text additional comments, of which 483 responses were considered in-scope. Six main themes were identified: (1) experiences of psychiatric medication, (2) challenges to reducing/stopping psychiatric medication, (3) strategies used to reduce/stop psychiatric medication, (4) outcomes of reducing/stopping psychiatric medication, (5) emotional context and (6) areas for improvement.

CONCLUSION

This study identified numerous challenges faced by respondents when discontinuing psychiatric medication, the uncertainty that prevails in terms of the best tapering strategy and the emotional impact of taking and/or stopping psychiatric medication. The findings also highlight the importance of support during the discontinuation process, in particular psychosocial supports, and areas that could be targeted to improve the withdrawal process.

PATIENT OR PUBLIC CONTRIBUTION

An international Steering Group was established to oversee and guide the PSP study in accordance with the James Lind Alliance guidance and Patient and Public Involvement principles. Patient and public groups were represented on the Steering Group and were among the three key stakeholder groups (i.e., people with lived experience of taking and/or stopping psychiatric medication, family members/carers/supporters and healthcare professionals) engaged with throughout.