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Guidelines or mindlines? A qualitative study exploring what knowledge informs psychiatrists decisions about antipsychotic prescribing

Guidelines or mindlines? A qualitative study exploring what knowledge informs psychiatrists decisions about antipsychotic prescribing
Guidelines or mindlines? A qualitative study exploring what knowledge informs psychiatrists decisions about antipsychotic prescribing
Background: Gabbay and le May (2004) argue that successful implementation of research evidence requires a better understanding of clinical "sense-making" and how different knowledge is used in practice.
Aims: To explore the psychiatrists decision-making about prescribing of antipsychotic medication and to identify potential barriers to the implementation of guidelines for the pharmacological management of schizophrenia.
Method: Qualitative study using semi-structured interviews with 22 consultant psychiatrists.
Results: We identified four types of knowledge: acquired; interpreted; individual experience; and contextual. These were grouped within a personal or a scientific perspective, and located at the level of the "self" or "others". Each of these sources of knowledge informs "mindlines"- the personalized and tacit sense-making - on which prescribing decisions were based.
Conclusions: This study indicates that guidelines are only one, component of the knowledge consultant psychiatrists might use when making decisions about the pharmacological management of patients with schizophrenia. The presence of competing and complex sources of knowledge and the use of mindlines could explain why the simple dissemination of guidelines will not change prescribing practice.
Declaration of interest: The research on which this paper was based was funded by NHS South West Executive R&D Programme Development Grant (PDG/09/05.99/Harrison).
prescribing, qualitative research, clinical practice guidelines
9-17
Barley, Madeline
a4d6453d-28fe-4d7c-9971-d6b30a289ccf
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Chilvers, Rupatharshini
ea52d13d-3030-4841-b29c-65395253b205
Sipos, Attila
d9691309-a54e-4822-9dc7-2658de62bff1
Harrison, Glynn
7897c512-f966-4530-98b8-a0a50278a0d3
Barley, Madeline
a4d6453d-28fe-4d7c-9971-d6b30a289ccf
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Chilvers, Rupatharshini
ea52d13d-3030-4841-b29c-65395253b205
Sipos, Attila
d9691309-a54e-4822-9dc7-2658de62bff1
Harrison, Glynn
7897c512-f966-4530-98b8-a0a50278a0d3

Barley, Madeline, Pope, Catherine, Chilvers, Rupatharshini, Sipos, Attila and Harrison, Glynn (2008) Guidelines or mindlines? A qualitative study exploring what knowledge informs psychiatrists decisions about antipsychotic prescribing. Journal of Mental Health, 17 (1), 9-17. (doi:10.1080/09638230701498358).

Record type: Article

Abstract

Background: Gabbay and le May (2004) argue that successful implementation of research evidence requires a better understanding of clinical "sense-making" and how different knowledge is used in practice.
Aims: To explore the psychiatrists decision-making about prescribing of antipsychotic medication and to identify potential barriers to the implementation of guidelines for the pharmacological management of schizophrenia.
Method: Qualitative study using semi-structured interviews with 22 consultant psychiatrists.
Results: We identified four types of knowledge: acquired; interpreted; individual experience; and contextual. These were grouped within a personal or a scientific perspective, and located at the level of the "self" or "others". Each of these sources of knowledge informs "mindlines"- the personalized and tacit sense-making - on which prescribing decisions were based.
Conclusions: This study indicates that guidelines are only one, component of the knowledge consultant psychiatrists might use when making decisions about the pharmacological management of patients with schizophrenia. The presence of competing and complex sources of knowledge and the use of mindlines could explain why the simple dissemination of guidelines will not change prescribing practice.
Declaration of interest: The research on which this paper was based was funded by NHS South West Executive R&D Programme Development Grant (PDG/09/05.99/Harrison).

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More information

Published date: February 2008
Keywords: prescribing, qualitative research, clinical practice guidelines

Identifiers

Local EPrints ID: 50369
URI: https://eprints.soton.ac.uk/id/eprint/50369
PURE UUID: 0b13e747-3974-4102-9d62-7597d87af6e0
ORCID for Catherine Pope: ORCID iD orcid.org/0000-0002-8935-6702

Catalogue record

Date deposited: 20 Feb 2008
Last modified: 20 Jul 2019 00:59

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