Toward Multidisciplinary Tools for Complex Clinical Psychopharmacology Cases: A Qualitative Study with French Healthcare Professionals
Résumé
Purpose: Psychopharmacology prescriptions are complex, partly due to the complexity of the relationship between diagnosis and its etiology, as well as the iatrogenic impact on symptomatology. Many multidisciplinary tools exist to optimize their management and improve evidence-based practice. However, their multidisciplinary integration seems to be a challenge. This study aimed to collect information on barriers and facilitators perceived by hospital health professionals regarding the use of multidisciplinary tools to address complex situations in psychopharmacology.
Research Design and Methods: A mixed-methods research approach using semi-structured interviews was conducted with physicians and pharmacists from 11 hospital institutions. An interview guide developed from the COM-B model (Capability, Opportunity, and Motivation -Behavior) was used to identify barriers and facilitators to the use of multidisciplinary tools. Data were analyzed using thematic analysis to identify emerging themes and mapped to the COM-B model.
Results: 28 professionals were interviewed. Identified barriers were: lack of knowledge and time to address complex situations, incomplete medical records, lack of easily accessible multidisciplinary tools, insufficient levels of evidence in psychopharmacology. Identified facilitators were: continuing education, communication and networking among professionals, implementation of adapted and shared resources, deprescribing, awareness of medication-induced iatrogenesis, accessibility of tools for all populations.
Conclusion: Identified barriers and facilitators in the use of multidisciplinary tools for complex situations in psychopharmacology helped to model factors that enable behavior change. Answers need to be provided to help professionals ensure and optimize psychopharmacological therapies.
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