Abstract
OBJECTIVES: To explore the patient and informal-carer reported factors that influence prescribing decisions in the management of borderline personality disorder (BPD).
DESIGN: The study employed a qualitative methodology of semi-structured interviews with patients and informal carers to examine perspectives on prescribing decisions and the factors shaping them.
SETTING: Interviews were conducted across both primary and secondary care settings in England.
PARTICIPANTS: A total of 10 participants were recruited for the study, comprising eight females and two males, all aged 18 years or older. Participants either had a formal diagnosis of BPD or were informal carers of individuals diagnosed with BPD. All participants had experience with the prescribing of medication for the management of BPD.
RESULTS: Thematic analysis, employing both inductive and deductive strategies and informed by agency theory, yielded three interrelated themes: prescribing for symptom relief, the impact of risk on prescribing and difficulties in accessing services. Participants described medication as a necessary means of managing distress, especially when access to psychological therapies was constrained. Despite awareness of potential adverse effects, many expressed a strong desire to make their own decision around medication.
CONCLUSIONS: Improving clarity around the likelihood of both symptomatic relief and potential adverse effects through co-designed informational resources may support more informed decision-making in the treatment of BPD. Furthermore, to change prescribing patterns, systemic gaps in the provision of long-term psychological therapies must be addressed.
| Original language | English |
|---|---|
| Article number | e108927 |
| Number of pages | 9 |
| Journal | BMJ Open |
| Volume | 15 |
| Issue number | 12 |
| Early online date | 3 Dec 2025 |
| DOIs | |
| Publication status | Published - 3 Dec 2025 |
Bibliographical note
Copyright © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.
Data Access Statement
Data may be obtained from a third party and are not publicly available. The interview data supporting this study will not be publicly available due to the sensitive nature of the information. Participants did not provide consent for public sharing. However, anonymised or de-identified summaries of the data, if appropriate, may be available upon request. Please contact jc517@ bath.ac. uk.Keywords
- Humans
- Borderline Personality Disorder/drug therapy
- Female
- Male
- Qualitative Research
- Adult
- Caregivers/psychology
- Middle Aged
- Interviews as Topic
- England
- Decision Making
- Young Adult
- United Kingdom