Medication optimisation in severe mental illness (MEDIATE): protocol for a realist review

Area of Science:

• Psychiatry
• Health Services Research
• Realist Evaluation

Background:

• Severe mental illness (SMI) is linked to increased morbidity and mortality.
• Individuals with SMI often face challenges with complex medication regimens and non-adherence.
• Optimizing medication use requires a collaborative decision-making process.

Purpose of the Study:

• To develop program theories for optimizing medication use in severe mental illness.
• To understand the context, mechanisms, and outcomes related to medication adherence in SMI.
• To identify strategies for improving medication management through a realist approach.

Main Methods:

• A six-stage realist evaluation methodology will be employed.
• Extensive collaboration with lived experience groups and practitioner stakeholders.
• Development and refinement of program theories using secondary data analysis.

Main Results:

• Initial program theories will be formulated based on expert and stakeholder input.
• Secondary data searches will refine these theories.
• Final program theories will explain causal mechanisms for optimizing medication use in SMI.

Conclusions:

• Refined program theories will guide interventions to improve medication adherence in SMI.
• The realist approach provides a framework for understanding complex healthcare interventions.
• Findings will inform future research and clinical practice for SMI medication management.