Does race affect prescribing for acute psychosis? Evaluation by a case vignette

Area of Science:

• Psychiatry
• Clinical Psychology
• Health Services Research

Background:

• Black populations are disproportionately represented in mental health services.
• Antipsychotic prescribing patterns vary by race in some nations.
• Previous UK research indicated no significant racial disparities in antipsychotic prescribing.

Purpose of the Study:

• To investigate potential racial bias in antipsychotic prescribing.
• To validate or refute anecdotal claims of racial differences in treatment.
• To compare prescriber choices for Black versus White patients using case vignettes.

Main Methods:

• Two case vignettes, identical except for patient ethnicity (Black or White), were distributed to medical prescribers.
• Prescribers from the South London and Maudsley NHS Trust received either the Black or White vignette.
• Prescribing outcomes measured included dose, antipsychotic type, route, and polypharmacy.

Main Results:

• 123 completed case studies were analyzed.
• No statistically significant differences were observed in prescribing patterns (dose, type, route, polypharmacy) based on the ethnicity presented in the case vignette.
• Prescribing decisions were consistent across different staff grades.

Conclusions:

• Antipsychotic prescribing for Black and White patients in the UK is broadly similar.
• The study's findings align with previous UK research, challenging anecdotal evidence of racial bias.
• Clinical and theoretical assessments indicate comparable treatment approaches irrespective of patient race.