Reviewing long-term antidepressants can reduce drug burden: a prospective observational cohort study

Johnson, Chris F; Macdonald, Hector J; Atkinson, Pauline; Buchanan, Alasdair I; Downes, Noreen; Dougall, Nadine

Abstract

BACKGROUND: Antidepressant prescribing continues to rise. Contributing factors are increased long-term prescribing and possibly the use of higher selective serotonin re-uptake inhibitor (SSRI) doses.

AIM: To review general practice patients prescribed the same antidepressant long-term (≥2 years) and evaluate prescribing and management pre and post-review.

DESIGN AND SETTING: Prospective observational cohort study using routine data from 78 urban general practices, Scotland.

METHOD: All patients prescribed antidepressants (excluding amitriptyline) for ≥2 years were identified from records November 2009 to March 2010. GPs selected patients for face-to-face review of clinical condition and medication, December 2009 to September 2010. Pre- and post-review data were collected; average antidepressant doses and changes in prescribed daily doses were calculated. Onward referral to support services was recorded.

RESULTS: 8.6% (33 312/388 656) of all registered patients were prescribed an antidepressant, 47.1% (15 689) were defined as long-term users and 2849 (18.2%) were reviewed. 811 (28.5%) patients reviewed had a change in antidepressant therapy: 7.0% stopped, 12.8% reduced dose, 5.3% increased dose, and 3.4% changed antidepressant, resulting in 9.5% (95% CI = 9.1% to 9.8% P

Citation

Johnson, C. F., Macdonald, H. J., Atkinson, P., Buchanan, A. I., Downes, N., & Dougall, N. (2012). Reviewing long-term antidepressants can reduce drug burden: a prospective observational cohort study. British Journal of General Practice, 62(604), 773-779. https://doi.org/10.3399/bjgp12x658304

• Journal Article Type: Article
• Acceptance Date: Jun 8, 2012
• Online Publication Date: Oct 29, 2012
• Publication Date: Nov 1, 2012
• Deposit Date: Sep 23, 2016
• Journal: British Journal of General Practice
• Print ISSN: 0960-1643
• Electronic ISSN: 1478-5242
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Volume: 62
• Issue: 604
• Pages: 773-779
• DOI: https://doi.org/10.3399/bjgp12x658304
• Keywords: Antidepressant, drug therapy, depression, primary care,
• Public URL: http://researchrepository.napier.ac.uk/Output/388923