Evidence map›Paper›PMID 35953808›Full record

ArticleBMC psychiatry2022

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial.

Lavanya J Thana, Lesley O'Connell, Alexandra Carne-Watson, Abhishek Shastri, Arunan Saravanamuthu, Natasha Budhwani, Sandra Jayacodi, Verity C Leeson, Jasna Munjiza, Sofia Pappa and 3 more

Open access · goldAbstract readControlled Clinical Trial
In one paragraph

Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Lavanya J ThanaDivision of Psychiatry, Commonwealth Building, Imperial College London, Du Cane Road, London, W12 0NN, UK.
Lesley O'ConnellDivision of Psychiatry, Commonwealth Building, Imperial College London, Du Cane Road, London, W12 0NN, UK.
Alexandra Carne-WatsonTees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
Abhishek ShastriCentral and North West London NHS Foundation Trust, London, UK.
Arunan SaravanamuthuCentral and North West London NHS Foundation Trust, London, UK.
Natasha BudhwaniWest London NHS Health Trust, London, UK.
Sandra JayacodiCentral and North West London NHS Foundation Trust, London, UK.
Verity C LeesonDivision of Psychiatry, Commonwealth Building, Imperial College London, Du Cane Road, London, W12 0NN, UK.
Jasna MunjizaCentral and North West London NHS Foundation Trust, London, UK.
Sofia PappaWest London NHS Health Trust, London, UK.
Elizabeth HughesSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.
Joe ReillyTees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
Mike J CrawfordDivision of Psychiatry, Commonwealth Building, Imperial College London, Du Cane Road, London, W12 0NN, UK. m.crawford@imperial.ac.uk.
Central and North West London NHS Foundation Trust · GBCommonwealth Education Trust · GBImperial College London · GBTees, Esk and Wear Valleys NHS Foundation Trust · GBWest London Mental Health NHS Trust · GBEdinburgh Napier University · GB

Funding

Department of Health
6 · The paper itself

Abstract

backgroundMore than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial.

methodsWe developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis.

resultsNine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients' mental stability, mutual discomfort and embarrassment about discussing a "taboo" subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these "hidden" side effects.

conclusionThe identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of sexual dysfunction among people with psychosis, the evaluation and implementation of interventions to manage them will continue to be challenging unless NHS leaders and senior clinicians demonstrate greater commitment to changing current clinical practice.

trial registrationCurrent Controlled Trials ISRCTN12307891.

Indexed as

Antipsychotic AgentsMental Health ServicesPsychotic DisordersHumansReferral and ConsultationState MedicineAntipsychotic AgentsAntipsychotic medicationPsychotic disordersSexual dysfunction

Identifiers

PMID35953808
PMCPMC9373458
OpenAlexW4291000180

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.