System struggles and substitutes: a qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents

Murphy, Andrea L., Gardner, David M., Kisely, Steve, Cooke, Charmaine A., Kutcher, Stanley P. and Hughes, Jean (2016) System struggles and substitutes: a qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents. Clinical Child Psychology and Psychiatry, 21 4: 634-648. doi:10.1177/1359104515617518


Author Murphy, Andrea L.
Gardner, David M.
Kisely, Steve
Cooke, Charmaine A.
Kutcher, Stanley P.
Hughes, Jean
Title System struggles and substitutes: a qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents
Journal name Clinical Child Psychology and Psychiatry   Check publisher's open access policy
ISSN 1461-7021
1359-1045
Publication date 2016-10-01
Sub-type Article (original research)
DOI 10.1177/1359104515617518
Open Access Status DOI
Volume 21
Issue 4
Start page 634
End page 648
Total pages 15
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2017
Language eng
Formatted abstract
There are significant controversies regarding rising antipsychotic prescription trends in children and adolescents. Many pharmacoepidemiology trend studies have been published, and interpretations of these data are helpful in explaining what is happening in prescribing practices, but not why these patterns exist. There is a lack of qualitative data in this area, and the experience of prescribing antipsychotics to children and adolescents has not been adequately researched. We conducted a qualitative study using an interpretive phenomenological analysis of physicians' experiences of antipsychotic prescribing to children and adolescents. Prescribers participated in individual interviews and a focus group. We used a staged approach for data analysis of transcriptions. In all, 11 physicians including psychiatrists and general practitioners participated in our study. We identified themes related to context, role and identity, and decision-making and filtering. Struggles with health system gaps were significant leading to the use of antipsychotics as substitutes for other treatments. Physicians prescribed antipsychotics to youth for a range of indications and had significant concerns regarding adverse effects. Our results provide knowledge regarding the prescribers' experience of antipsychotics for children and adolescents. Important gaps exist within the health system that are creating opportunities for the initiation and continued use of these agents.
Keyword Antipsychotics
Children and adolescents
Disruptive behavior disorders
Physicians
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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