Health professionals' attitudes to depot injection antipsychotic medication: a systematic review

Accessible summary The attitudes of mental health professionals towards medication play a crucial and influential role in service users' uptake of treatments. Evidence suggests that when service users receive their medication via depot injection, compliance improves and relapse rates are reduced. It is vital that mental health service users are involved in decision making about the mode by which their antipsychotic medication is delivered. Despite this, few studies have investigated the attitudes and beliefs that healthcare professionals hold about depot medication. No reviews have looked at health professionals' attitudes towards depot medication alone. Depots are seen as old fashioned, stigmatizing, causing side effects and being costly, and they are often not prescribed because of a presumed adherence to oral medication. In the current study it has been found that research in this field is sparse, and studies have mixed quality. An issue that should be investigated when looking at prescribing of depot medication is that of non-medical prescribers, especially nurses. Nurses have a different relationship to the service users when compared with consultant psychiatrists, and this can have an impact on service users' choice of medication. Abstract Healthcare professionals are key providers of information about antipsychotic medication and may have a significant influence on the decisions that service users make about how their medication is delivered. This systematic review aimed to explore health professionals' attitudes and beliefs towards antipsychotic depot medication. A systematic search of AMED, BNI, CINAHL, EMBASE, HEALTH BUSINESS ELITE, HMIC, MEDLINE and PsycINFO was carried out, as well as hand searches of journals and citation searches. Studies were selected if the terms 'attitudes/beliefs' and 'depot/injection' were included in the title or abstract, if health professionals were participants in the study and if original data were included. The search strategy produced 131 papers. Eight relevant studies were then selected for the review. They included six cross-sectional surveys and two qualitative studies. It was shown that the research carried out is still very sparse. Depots are seen as old fashioned, stigmatizing, causing side effects and being costly, and they are often not prescribed because of a presumed adherence to oral medication. More research needs to be carried out to further explore these issues, to look at the role of non-medical prescribers and explore the relationship between health professionals' attitudes and those of service users.