Toward Multidisciplinary Tools for Complex Clinical Psychopharmacology Cases: A Qualitative Study with French Healthcare Professionals

Abstract

Matthieu Lebrat,1,2 Rachel Megard,1 Anne-Cecile Gallo Blandin,3 Nicolas Franck,1,4,5 Luc Zimmer2,5– 7 1Pôle Centre Rive Gauche, Centre Hospitalier Le Vinatier, Lyon, France; 2Hospices Civils de Lyon, Lyon, France; 3Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France; 4UMR 5229 CNRS, Centre Ressource de Réhabilitation psychosociale, Centre Hospitalier Le Vinatier, Lyon, France; 5Université Claude Bernard Lyon 1, Lyon, France; 6Lyon Neuroscience Research Center, INSERM, CNRS, Lyon, France; 7CERMEP, Lyon, FranceCorrespondence: Matthieu Lebrat, Pôle Centre Rive Gauche, Centre Hospitalier Le Vinatier, BP 30039 - 95 Bd Pinel 69678 Bron Cedex, Lyon, France, Email [email protected]: 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.Keywords: patient care team, psychopharmacology, hospitals, mental health, capability – opportunity - motivation – behavior (COM-B) model

Keywords

• patient care team
• psychopharmacology
• hospitals
• mental health
• capability – opportunity - motivation – behavior (com-b) model