Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership

• Published in: BMJ open 2024-11, Vol.14 (11), p.e088266
• Main Authors: Boland, Miriam, Higgins, Agnes, Beecher, Claire, Bracken, Pat, Burn, Wendy, Cody, Anne, Framer, Adele, Gronlund, Toto, Horowitz, Mark, Huff, Christy, Jayacodi, Sandra, Keating, Dolores, Kessler, David, Konradsson-Geuken, Åsa, Lamberson, Nicole, Montagu, Luke, Smith, Ruth, Cadogan, Cathal
• Format: Article
• Language: English
• Subjects: Adult; Caregivers - psychology; Female; Health Personnel - psychology; Health Priorities; Humans; Male; Mental Disorders - drug therapy; Mental Health; Middle Aged; Original Research; Psychotropic Drugs - therapeutic use; Stakeholder Participation; Surveys and Questionnaires
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-088266

The objective of this study is to identify the top 10 research priorities on reducing and stopping psychiatric medication that reflect the perspectives and unmet needs of three key stakeholder groups (people with lived experience, family members/carers/supporters and healthcare professionals). A priority-setting partnership was conducted using the James Lind Alliance's seven-step process. This involved (1) creating an international Steering Group of key stakeholder representatives and (2) identifying potential partners; (3) gathering stakeholders' uncertainties about reducing and stopping psychiatric medication using an online survey and summarising the survey responses; (4) checking the summary questions against existing evidence and verifying uncertainties; (5) shortlisting the questions using a second online survey; (6) determining the top 10 research questions through a prioritisation workshop; and (7) disseminating the results. A total of 3635 questions were collected in the initial survey from 884 respondents of which 32 questions were verified as uncertainties. These questions were then ranked in a second online survey by 526 respondents and the findings discussed in a final prioritisation workshop by 30 participants to produce the final top 10 list of research questions. These questions cover a range of areas including the most effective ways of safely reducing/stopping psychiatric medication and providing support to individuals undergoing the discontinuation process, as well as the best ways to educate healthcare professionals on this topic. The top 10 list of research priorities was produced through extensive engagement with key stakeholders and highlights important uncertainties and gaps in the existing evidence base that need to be addressed by future research.