Exploration of GP perspectives on deprescribing antidepressants: a qualitative study
| Autor: | Philip Green, Liam G. Glynn, Justin Graffi, Dervla Kelly, Peter Hayes, John McFarland, Maria Noonan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
quality in healthcare Attitude of Health Personnel 03 medical and health sciences primary care 0302 clinical medicine Deprescriptions Older patients General Practitioners Medicine Humans 030212 general & internal medicine Depression (differential diagnoses) Qualitative Research business.industry General Medicine Talk therapy Antidepressive Agents 030227 psychiatry Discontinuation Family medicine depression & mood disorders Antidepressant Thematic analysis Deprescribing business General practice / Family practice Ireland Qualitative research |
| Zdroj: | BMJ Open BMJ Open, Vol 11, Iss 4 (2021) |
| ISSN: | 2044-6055 |
| Popis: | ObjectiveOur aim was to explore general practitioners’ (GPs) perceptions and experiences of discontinuing antidepressants.Study designA qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a thematic analysis framework.SettingGPs affiliated with a university education and research network for general practice in Ireland.ParticipantsA purposive sample of GPs (n=10).ResultsFive themes emerged: shared decision-making; personalised therapy; medication-tapering toolkit; health service factors and concerns around tapering. GPs described being less likely to engage in deprescribing for patients with long-term and/or recurrent depression, older patients and those with comorbidities due to fear of relapse. Access to evidence-based psychological therapies, guidelines, information on rates of relapse, patient leaflets on discontinuing antidepressants and reminder prompts on GP-prescribing software were suggested to optimise appropriate antidepressant discontinuation. There was some suggestion that patients may use antidepressants for longer when talk therapy is not available or taken up.ConclusionsGPs are largely confident in their role of managing mild-to-moderate depression and deprescribing antidepressants. This study provides an insight into factors that influence GPs’ decisions to deprescribe antidepressants. More information on rates of relapse after discontinuation would be helpful to inform decision-making. |
| Databáze: | OpenAIRE |
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