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

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posted on 2023-06-09, 11:32 authored by Renske C Bosman, Klaas M Huijbregts, Pete F M Verhaak, Henricus G Ruhé, Harm van MarwijkHarm van Marwijk, Anton J L M Van Balkom, Neeltje Batelaan
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.

History

Publication status

  • Published

File Version

  • Published version

Journal

British Journal of General Practice

ISSN

0960-1643

Publisher

Royal College of General Practitioners

Issue

651

Volume

66

Article number

e708-e719

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2018-01-12

First Open Access (FOA) Date

2018-01-12

First Compliant Deposit (FCD) Date

2018-01-12

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