{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:40:59Z","timestamp":1787319659431,"version":"build-2736575974"},"reference-count":35,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,14]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the patient and informal-carer reported factors that influence prescribing decisions in the management of borderline personality disorder (BPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Interviews were conducted across both primary and secondary care settings in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108927","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:21:06Z","timestamp":1764786066000},"page":"e108927","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Patients\u2019 and informal carers\u2019 insights into influences on prescribing in borderline personality disorder: a qualitative interview study in the UK"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3875-5528","authenticated-orcid":false,"given":"Joshua","family":"Confue","sequence":"first","affiliation":[{"name":"University of Bath, Bath, UK"},{"name":"Lincolnshire Partnership Trust, Lincoln, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-9704","authenticated-orcid":false,"given":"Ian","family":"Maidment","sequence":"additional","affiliation":[{"name":"Pharmacy, Aston University, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2617-4098","authenticated-orcid":false,"given":"Matthew","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"2026010703453640000_15.12.e108927.1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph15122763","article-title":"Exploring General Practitioners\u2019 Views and Experiences of Providing Care to People with Borderline Personality Disorder in Primary Care: A Qualitative Study in Australia","volume":"15","author":"Wlodarczyk","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"2026010703453640000_15.12.e108927.2","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/S0924-9338(15)30162-0","article-title":"A Nationwide Study of Mortality in Patients with Borderline Personality Disorder","volume":"30","author":"Kj\u00e6r","year":"2015","journal-title":"Eur Psychiatry"},{"key":"2026010703453640000_15.12.e108927.3","doi-asserted-by":"crossref","first-page":"102032","DOI":"10.1016\/j.ijlp.2024.102032","article-title":"Global prevalence of borderline personality disorder and self-reported symptoms of adults in prison: A systematic review and meta-analysis","volume":"97","author":"Dahlenburg","year":"2024","journal-title":"Int J Law Psychiatry"},{"key":"2026010703453640000_15.12.e108927.4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/wps.21156","article-title":"Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies","volume":"23","author":"Leichsenring","year":"2024","journal-title":"World Psychiatry"},{"key":"2026010703453640000_15.12.e108927.5","doi-asserted-by":"crossref","first-page":"18029","DOI":"10.1038\/nrdp.2018.29","article-title":"Borderline personality disorder","volume":"4","author":"Gunderson","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"2026010703453640000_15.12.e108927.6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.comppsych.2017.04.004","article-title":"What do clinicians treat: Diagnoses or symptoms? 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