Factors That Influence Prescribing in Borderline Personality Disorder: A Systematic Review

Area of Science:

• Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Borderline Personality Disorder (BPD) is a complex psychiatric condition impacting individuals and their social circles.
• No specific medication is licensed for BPD, yet psychotropic prescriptions are frequent.
• Psychotropic medications carry inherent risks and adverse events.

Purpose of the Study:

• To systematically review factors influencing psychotropic prescribing in adult BPD patients.
• To identify demographic and relational elements affecting medication choices for BPD.

Main Methods:

• Systematic review of EMBASE, PsycINFO, PubMed, EThOS, and Web of Science databases.
• Inclusion of 13 diverse studies (7 quantitative, 6 qualitative) from 102 unique identified studies.
• Synthesis of quantitative and qualitative data to explore prescribing drivers.

Main Results:

• Older patients and those with comorbid conditions were more likely to receive prescriptions.
• The patient-healthcare professional relationship emerged as a critical factor from both patient and HCP perspectives.
• Care pathway elements also significantly influenced prescribing decisions.

Conclusions:

• Prescribing for BPD is prevalent but influenced by multiple factors beyond clinical indication.
• Healthcare professionals' awareness of their role in the patient relationship is vital for appropriate BPD treatment.
• Further research is needed to understand and optimize psychotropic prescribing in BPD management.