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How do people make decisions about whether to continue or discontinue taking long-term antidepressants for depression? A critical interpretive synthesis

How do people make decisions about whether to continue or discontinue taking long-term antidepressants for depression? A critical interpretive synthesis
How do people make decisions about whether to continue or discontinue taking long-term antidepressants for depression? A critical interpretive synthesis
Southampton-led research using the CPRD database has shown that the prevalence of depression rose by only 3.9% between 2009 and 2013, while the number of prescriptions rose by 36% over the same period, which is due to the rise of long-term antidepressant use.

While some long-term treatment of depression may be indicated according to evidence-based depression guidelines, much of it may be inappropriate, as some individuals are defined by having at least one key symptom of depression, but with insufficient other symptoms and/or functional impairment to meet the full diagnosis of major depression. Given the evidence that GPs are prescribing longer courses of antidepressant treatment, it has been recommended that guidelines need to include more information on how recurrent and long-term depression should be managed in primary care.

Up to a half of patients on long-term antidepressants have no clinical indications to continue medical treatment. There is concern that few review consultations are carried out with patients who are long-term antidepressant users, with the percentage of patients reviewed during each year of antidepressant therapy decreasing over 10 years. There are no formal processes within primary care for GPs to follow in order to carry out these reviews. Reviewing long-term antidepressant use can reduce drug burden.

The evidence suggests that the way in which longer-term depression is managed and reviewed in primary care should be explored. Furthermore, it is important to explore what factors may influence individuals’ decisions to continue or discontinue long-term antidepressant treatment for their depression.
CRD42016053343
Dewar-Haggart, Rachel
7ae70377-352a-4297-9798-a6aed0e1c04b
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Bishop, Felicity
1f5429c5-325f-4ac4-aae3-6ba85d079928
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Dewar-Haggart, Rachel
7ae70377-352a-4297-9798-a6aed0e1c04b
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Bishop, Felicity
1f5429c5-325f-4ac4-aae3-6ba85d079928
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af

Dewar-Haggart, Rachel, Kendrick, Tony, Muller, Ingrid, Bishop, Felicity and Geraghty, Adam (2016) How do people make decisions about whether to continue or discontinue taking long-term antidepressants for depression? A critical interpretive synthesis 5pp. (CRD42016053343).

Record type: Monograph (Working Paper)

Abstract

Southampton-led research using the CPRD database has shown that the prevalence of depression rose by only 3.9% between 2009 and 2013, while the number of prescriptions rose by 36% over the same period, which is due to the rise of long-term antidepressant use.

While some long-term treatment of depression may be indicated according to evidence-based depression guidelines, much of it may be inappropriate, as some individuals are defined by having at least one key symptom of depression, but with insufficient other symptoms and/or functional impairment to meet the full diagnosis of major depression. Given the evidence that GPs are prescribing longer courses of antidepressant treatment, it has been recommended that guidelines need to include more information on how recurrent and long-term depression should be managed in primary care.

Up to a half of patients on long-term antidepressants have no clinical indications to continue medical treatment. There is concern that few review consultations are carried out with patients who are long-term antidepressant users, with the percentage of patients reviewed during each year of antidepressant therapy decreasing over 10 years. There are no formal processes within primary care for GPs to follow in order to carry out these reviews. Reviewing long-term antidepressant use can reduce drug burden.

The evidence suggests that the way in which longer-term depression is managed and reviewed in primary care should be explored. Furthermore, it is important to explore what factors may influence individuals’ decisions to continue or discontinue long-term antidepressant treatment for their depression.

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Published date: 30 December 2016

Identifiers

Local EPrints ID: 453060
URI: http://eprints.soton.ac.uk/id/eprint/453060
DOI: CRD42016053343
PURE UUID: bb0951ec-d84a-48fe-a7c0-ac3d37593cca
ORCID for Rachel Dewar-Haggart: ORCID iD orcid.org/0000-0002-3757-1152
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133
ORCID for Felicity Bishop: ORCID iD orcid.org/0000-0002-8737-6662
ORCID for Adam Geraghty: ORCID iD orcid.org/0000-0001-7984-8351

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Date deposited: 07 Jan 2022 17:50
Last modified: 12 Jan 2022 02:42

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