Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care

Bosman, Renske C, Huijbregts, Klaas M, Verhaak, Pete F M, Ruhé, Henricus G, van Marwijk, Harm W J, Van Balkom, Anton J L M and Batelaan, Neeltje (2016) Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care. British Journal of General Practice, 66 (651). e708-e719. ISSN 0960-1643

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Abstract

Background
Antidepressant use is often prolonged in patients with anxiety and/or depressive disorder(s) compared with recommendations in treatment guidelines to discontinue after sustained remission.

Aim
To unravel the motivations of patients and GPs causing long-term antidepressant use and to gain insight into possibilities to prevent unnecessary long-term use. Design and setting Qualitative study using semi-structured, in-depth interviews with patients and GPs in the Netherlands.

Method
Patients with anxiety and/or depressive disorder(s) (n = 38) and GPs (n = 26) were interviewed. Innovatively, the interplay between patients and their GPs was also investigated by means of patient-GP dyads (n = 20).

Results
The motives and barriers of patients and GPs to continue or discontinue antidepressants were related to the availability of supportive guidance during discontinuation, the personal circumstances of the patient, and considerations of the patient or GP. Importantly, dyads indicated a large variation in policies of general practices around long-term use and continuation or discontinuation of antidepressants. Dyads further indicated that patients and GPs seemed unaware of each other's (mismatching) expectations regarding responsibility to initiate discussing continuation or discontinuation.

Conclusion
Although motives and barriers to antidepressant continuation or discontinuation were related to the same themes for patients and GPs, dyads indicated discrepancies between them. Discussion between patients and GPs about antidepressant use and continuation or discontinuation may help clarify mutual expectations and opinions. Agreements between a patient and their GP can be included in a patient-tailored treatment plan.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User: Rosie Harvey
Date Deposited: 12 Jan 2018 08:38
Last Modified: 12 Jan 2018 08:52
URI: http://sro.sussex.ac.uk/id/eprint/72750

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