Hca 574 - 725: Decision Making in Health Care

Article Critique

HCA 574- 725: Decision Making in Health Care

Yagna Roopa Kasaraneni

        800981007        

Summary of The Article

The research article named “Mental health pharmacists views on shared decision-making (SDM) for antipsychotics in serious mental illness” attempts to know the views of mental health pharmacists on shared decision making process while prescribing anti-psychotics to patients with severe mental illness. This research made use of semi structured interviews among the secondary care mental health pharmacists in UK, that were recorded to analyze using inductive thematic analysis, a method of constant comparison. It emphasized on the previous research and literature review on SDM, its impact on clinical care delivery and notions of different participants including clinicians, service users in performing it. Its main area of interest is to know the themes of mental health pharmacists on using SDM in prescribing antipsychotics to individuals with severe mental health illness. It made an attempt to explore the results of SDM employed through multi-disciplinary approach in its success. This semi structured study has elucidated qualitative data pertaining to the required outcome. Results showed that pharmacists are very positive towards implementing SDM in clinical setting particularly in prescribing medications. Also, that they rather are supporting the effect of SDM in achieving better clinical outcomes in belief of increased adherence rates and patient satisfaction. This research, also tried to bring out the reasons for SDM not being successfully implemented in spite of being thought a very productive tool in clinical setting. The proposed barriers include, issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. It identified a need to work around these factors and find solutions or measures to overcome them in order to implement SDM on a wide range of services and achieve better outcomes. This article also identifies the role of pharmacists in practicing SDM. Pharmacists interviewed have expressed their interest in getting involved in SDM to better promote patient-centered effective care delivery.

Critique of The Decision Tool/Concept/Theory Used

First of all, though the research has attempted to conduct qualitative semi-structured interviews, the number of responses (13) were very less to arrive at generalized conclusions. This is because all the participants recruited for the study came from the Midlands region and may not be broadly representative of attitudes and experiences of mental health pharmacists nationally and internationally. Moreover, we cannot be sure how long the participants had worked in mental health for (other than more than 1 year), whether they have a formal mental health qualification or their area of practice. We relied on convenience and snowballing sampling and relatively small sample sizes; though they found data saturation with consistent themes identified and no new themes identified in the last set of interviews. Additionally, identifying participants via known contacts may have influenced the interview responses in relation to socially desirable responses.