Guidelines or mindlines? A qualitative study exploring what knowledge informs psychiatrists decisions about antipsychotic prescribing

Background: Gabbay and le May () argue that successful implementation of research evidence requires a better understanding of clinical “sense-making” and how different knowledge is used in practice.Aims: To explore the psychiatrists decision-making about prescribing of antipsychotic medication and to identify potential barriers to the implementation of guidelines for the pharmacological management of schizophrenia.Method: Qualitative study using semi-structured interviews with 22 consultant psychiatrists.Results: We identified four types of knowledge: acquired; interpreted; individual experience; and contextual. These were grouped within a personal or a scientific perspective, and located at the level of the “self” or “others”. Each of these sources of knowledge informs “mindlines”– the personalized and tacit sense-making – on which prescribing decisions were based.Conclusions: This study indicates that guidelines are only one, component of the knowledge consultant psychiatrists might use when making deci...