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

Abstract

Introduction: Informed consent is the process whereby individuals make decisions about their medical care. Information provision, presumption of capability and absence of coercion are three fundamental assumptions required to provide informed consent. Informed consent may be complex to achieve in the context of antipsychotic prescribing. This systematic review aimed to explore challenges relating to informed consent processes in antipsychotic prescribing in the UK. Method: This was a systematic review of the literature relating to informed consent in antipsychotic prescribing in community settings. Data were analysed using Framework analysis. Results: Twenty-eight articles were included. Information provision has been perceived as lacking for a long time. Capacity has often not been assumed and loss of capacity has sometimes been viewed as permanent. Power imbalances associated with prescriber status and legal framework surrounding the Mental Health Act can blur lines between coercion and persuasion. Discussion: Challenges relating to process of informed consent in antipsychotic prescribing have persisted throughout the last few decades. People prescribed antipsychotics need to be made aware of their effects in line with current research. Further research is required to develop models for best practices for informed consent.