Priorities for future research on reducing and stopping psychiatric medicines using a James Lind Alliance priority setting partnership: The PROTECT study protocol

Miriam Boland; Agnes Higgins; Claire Beecher; Pat Bracken; Wendy Burn; Anne Cody; Adele Framer; Toto Anne Gronlund; Mark Horowitz; Christy Huff; Sandra Jayacodi; Dolores Keating; David Kessler; Asa Konradsson Geuken; Nicole Lamberson; Luke Montagu; Brian Osborne; Ruth Smith; Cathal Cadogan

doi:10.12688/hrbopenres.13649.1

Priorities for future research on reducing and stopping psychiatric medicines using a James Lind Alliance priority setting partnership: The PROTECT study protocol

HRB Open Res. 2022 Nov 10:5:72. doi: 10.12688/hrbopenres.13649.1. eCollection 2022.

Authors

Miriam Boland¹, Agnes Higgins², Claire Beecher^{3

4}, Pat Bracken⁵, Wendy Burn^{6

7}, Anne Cody⁸, Adele Framer⁹, Toto Anne Gronlund¹⁰, Mark Horowitz¹¹, Christy Huff¹², Sandra Jayacodi¹³, Dolores Keating¹⁴, David Kessler¹⁵, Asa Konradsson Geuken^{16

17}, Nicole Lamberson^{12

18

19}, Luke Montagu²⁰, Brian Osborne²¹, Ruth Smith²², Cathal Cadogan¹

Affiliations

¹ School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
² School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
³ Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland.
⁴ School of Nursing and Midwifery, University of Galway, Galway, Ireland.
⁵ Independent Consultant Psychiatrist, West Cork, Ireland.
⁶ Past President of, Royal College of Psychiatrists, England, UK.
⁷ Consultant Psychiatrist, Leeds and York Partnership NHS Foundation Trust, England, UK.
⁸ Health Research Board, Dublin, Ireland.
⁹ SurvivingAntidepressants.org, California, USA.
¹⁰ James Lind Alliance, United Kingdom, UK.
¹¹ Research and Development Department, Goodmayes Hospital, North East London NHS Foundation Trust, London, UK.
¹² Benzodiazepine Information Coalition, Utah, USA.
¹³ Lived Experience Public Contributor, London, UK.
¹⁴ St John of God Hospital, Dublin, Ireland.
¹⁵ Centre for Academic Mental Health, Bristol Medical School, University of Bristol, England, UK.
¹⁶ Section of Neuropharmacology and Addiction Research, Department of Pharmaceutical Biosciences, Uppsala University, Sweden, Sweden.
¹⁷ European Federation of Associations of Families of People with Mental Illness, Belgium, Belgium.
¹⁸ International Institute for Psychiatric Drug Withdrawal, United Kingdom, UK.
¹⁹ Inner Compass Initiative's The Withdrawal Project, United States, USA.
²⁰ Council for Evidence-based Psychiatry, United Kingdom, UK.
²¹ Irish College of General Practitioners, Dublin, Ireland.
²² Public Partner, England, UK.

Abstract

Background: There is a growing number of service users looking to discontinue use of psychiatric medicines. Tapering is the recommended approach for reducing and/or discontinuing the use of psychiatric medicines. This involves gradually reducing the dose over time to minimise the potential for withdrawal symptoms. However, many uncertainties exist regarding the process of reducing and stopping psychiatric medicines. This study will use a James Lind Alliance Priority Setting Partnership to determine the Top 10 unanswered questions and uncertainties about reducing and stopping psychiatric medicines. Methods : The Priority Setting Partnership will be conducted using the James Lind Alliance methodology. It will involve seven stages: (i) creating an international Steering Group of representatives from key stakeholder groups that will include people with lived experience of taking and/or stopping psychiatric medicines, family members, carers/supporters and healthcare professionals, and identifying potential partners to support key activities (e.g. dissemination); (ii) gathering uncertainties about reducing and stopping psychiatric medicines from key stakeholders using an online survey; (iii) data processing and summarising the survey responses; (iv) checking the summary questions against existing evidence and verifying uncertainties; (v) shortlisting the questions using a second online survey; (vi) determining the Top 10 research questions through an online prioritisation workshop; (vii) disseminating results. Conclusions : This study will use a Priority Setting Partnership to generate a Top 10 list of research questions and uncertainties about reducing and stopping psychiatric medicines. This list will help to guide future research and deliver responsive and strategic allocation of research resources, with a view to ultimately improving the future health and well-being of individuals who are taking psychiatric medicines.

Keywords: Antidepressants; James Lind Alliance; Patient and Public Involvement; Priority Setting Partnership; antipsychotics; benzodiazepines; discontinuation; psychotropic drugs; tapering; withdrawal.

Grants and funding

Health Research Board Ireland [LP-HSR-2019-012]. Miriam Boland was supported by a 1252 Scholarship from the School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin.