A systematic review exploring challenges of informed consent processes in antipsychotic prescribing

Figures & data

Figure 1. PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only.

Table 1. Study/article characteristics.

Author (year)	Country	Type of paper	Sample size, Characteristics, Setting & diagnosis	Analytic approach
Bowler et al. (2000)	UK	Clinical Audit	65 patients notes audited Depot clinic, community mental health team Schizophrenia, Bipolar Affective disorder, Depression, Unspecified psychotic illness, No diagnosis at time of audit	N/A
Brabbins et al. (1996)	UK	Review	N/A	Selective review of papers addressing ethical arguments for and against obtaining informed consent from schizophrenic patients
Cancro et al. (1981)	USA	Discussion	N/A	N/A
Chaplin and Timehin (2002)	UK	Research	56 Six Community mental health teams and one rehabilitation centre in London Schizophrenia, Schizoaffective disorder, Bipolar disorder	Patient interviews, Questionnaires, Abnormal Involuntary Movement Scale, National Adult Reading Test. Data analysed quantitatively
Chaplin et al. (2007)	UK	Discussion	N/A	N/A
Davis et al. (1988)	USA	Discussion	N/A	N/A
Eastwood and Pugh (1997)	UK	Research	100 participants Prescribed depot neuroleptics within Norwich, Bury st Edmunds and Cambridge catchment areas 65% male, mean age 42.9 years 35% female, mean age 46.2 years	Patient interviews Semi-structured depot neuroleptic interviews Comprised of two parts: Information Patient satisfaction Data analysed using SPSS software
Freishtat and Einhorn (1981)	USA	Discussion	N/A	N/A
Goldbeck et al. (1999)	UK	Research	59 patients 34 (58%) male 25 (42%) Female Mean age 43.8 years Diagnoses: Schizophrenia schizoptypal, persistent delusional disorder, schizoaffective disorder, bipolar disorder, recurrent depressive disorder and Borderline personality disorder	Semi-structured interviews designed for the purpose of this study. Questions covered detail of all psychiatric medications, perceived benefits and drawbacks of depot, knowledge of potential side-effects as well patient patient’s perceptions of the importance of the medications they are taking and perceived consequences of discontinuation.
Goldfarb et al. (2012)	USA	Research	107 participants 42 (50.5%) providers 50 (46.7%) family members 3 (2.8%) patients prescribed medication for schizophrenia	Reverse web-based simulation (Showing a standardised doctor as filmed from the point of view of a patient) Participants viewed the video clip of the consultation and then asked to complete some follow-up questions.
Harris et al. (2002)	UK	Discussion	N/A	N/A
Higgins et al. (2006)	UK	Discussion	N/A	N/A
Kitamura (2005)	Japan	Review	N/A/A	Narrative review
Kleinman et al. (1989)	Canada	Research	48 participants 21 intervention group 13 male 8 female Mean age 31.2 27 comparison group 22 male 5 female Mean age 32.4 Patients with DSM III diagnosis of schizophrenia, clinically stable outpatients on neuroleptic medication for at least 6 months	MCQ containing 12 statements Analysis in SPSS
Kleinman et al. (1996)	Canada	Research	26 participants Patients with DSM III diagnosis of schizophrenia, clinically stable outpatients on neuroleptic medication for at least 6 months	Patients randomly allocated to educational review group or single-session group Patients completed post information questionnaire (MCQ) All patients re-assessed at minimum of 4 weeks and again at 2 years post interventions
Laugharne and Brown (1998)	UK/Australia	Discussion	N/A	N/A
Laugharne et al. (2004)	UK/Netherlands/Spain	Research	230 psychiatrists 81 UK 106 Dutch 43 Spanish	Postal questionnaire investigating attitudes to informing patients of long-term risks of neuroleptic medications, in particular TD
Linden and Chaskel (1981)	Germany	Research	85 participants 40% male 60% female Age range 20–75 years Outpatient clinic Patients diagnosed by attending psychiatrists as suffering from one of the schizophrenic disorders (ICD-295, WHO 1967)	Interviews using detailed interview guides and questionnaires
Masand et al. (2002)	USA	Research	Charts of 117 patients reviewed Outpatients maintained on conventional antipsychotics for at least 1 month	Mental health nots retrospectively reviewed between recruitment (may-Aug 1997) and January 1994 to find information addressing reasons for the continued use of conventional antipsychotics
Mcmurray (2002)	Canada	Discussion	N/A	N/A
Noor et al. (2019)	India	Research	72 participants 46 male 46 female Mean age 38 years Diagnosis of schizophrenia meeting ICD 10 criteria Prescribed antipsychotics in the last 6 months	MARS VassarStats and Microsoft Excel Descriptive statistics, odds ratios, chi-square
Pozón (2015)	Spain	Discussion	N/A	N/A
Read and Williams (2019)	UK/Australia	Research	832 respondents Female 77.0% Male 28.0% Mean age 43.1 years Most common diagnoses: Schizophrenia spectrum (28%), Bipolar disorder (24.9%) and Depression (24.3%) 30 countries	Online survey: Experiences of antidepressant and antipsychotic medication survey
Schachter et al. (1999)	Canada	Research	30 family physicians from teaching and non-teaching hospitals 83% Male 17% Female Mean age 44.3 years	Self -report questionnaire and interviews on behaviour and attitudes towards disclosure of information and documentation of informed consent
Schachter and Kleinman (2004)	Canada	Research	427 respondents 55% male 45% female Mean age 46.3 years Psychiatrists 84% prescribed antipsychotic medications to mean of 72.2 patients per year and median of 30 patients per year	Self-report questionnaires to assess whether psychiatrists disclosed information about antipsychotic medications and the risks of tardive dyskinesia. Two scales derived from the questionnaire: the behaviour scale and the antipsychotic attitude scale
Tryer (2000)	UK	Case report	N/A	N/A
Tryer et al. (1994)	UK	Discussion	N/A	N/A
Usher Rn et al. (1998)	Australia/Hong-Kong	Discussion	N/A	N/A

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