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Exploration of GP perspectives on deprescribing antidepressants: a qualitative study
OBJECTIVE: Our aim was to explore general practitioners’ (GPs) perceptions and experiences of discontinuing antidepressants. STUDY DESIGN: A qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a themati...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030471/ https://www.ncbi.nlm.nih.gov/pubmed/33820792 http://dx.doi.org/10.1136/bmjopen-2020-046054 |
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author | Kelly, Dervla Graffi, Justin Noonan, Maria Green, Philip McFarland, John Hayes, Peter Glynn, Liam |
author_facet | Kelly, Dervla Graffi, Justin Noonan, Maria Green, Philip McFarland, John Hayes, Peter Glynn, Liam |
author_sort | Kelly, Dervla |
collection | PubMed |
description | OBJECTIVE: Our aim was to explore general practitioners’ (GPs) perceptions and experiences of discontinuing antidepressants. STUDY DESIGN: A qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a thematic analysis framework. SETTING: GPs affiliated with a university education and research network for general practice in Ireland. PARTICIPANTS: A purposive sample of GPs (n=10). RESULTS: Five 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. CONCLUSIONS: GPs 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. |
format | Online Article Text |
id | pubmed-8030471 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-80304712021-04-27 Exploration of GP perspectives on deprescribing antidepressants: a qualitative study Kelly, Dervla Graffi, Justin Noonan, Maria Green, Philip McFarland, John Hayes, Peter Glynn, Liam BMJ Open General practice / Family practice OBJECTIVE: Our aim was to explore general practitioners’ (GPs) perceptions and experiences of discontinuing antidepressants. STUDY DESIGN: A qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a thematic analysis framework. SETTING: GPs affiliated with a university education and research network for general practice in Ireland. PARTICIPANTS: A purposive sample of GPs (n=10). RESULTS: Five 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. CONCLUSIONS: GPs 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. BMJ Publishing Group 2021-04-05 /pmc/articles/PMC8030471/ /pubmed/33820792 http://dx.doi.org/10.1136/bmjopen-2020-046054 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | General practice / Family practice Kelly, Dervla Graffi, Justin Noonan, Maria Green, Philip McFarland, John Hayes, Peter Glynn, Liam Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title | Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title_full | Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title_fullStr | Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title_full_unstemmed | Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title_short | Exploration of GP perspectives on deprescribing antidepressants: a qualitative study |
title_sort | exploration of gp perspectives on deprescribing antidepressants: a qualitative study |
topic | General practice / Family practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030471/ https://www.ncbi.nlm.nih.gov/pubmed/33820792 http://dx.doi.org/10.1136/bmjopen-2020-046054 |
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