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Research

GPs’ insights about discontinuing long-term antidepressant use: a qualitative study

Maria Donald, Riitta Partanen, Leah Sharman, Johanna Lynch, Genevieve A Dingle, Catherine Haslam and Mieke van Driel
British Journal of General Practice 17 January 2021; BJGP.2020.0913. DOI: https://doi.org/10.3399/BJGP.2020.0913
Maria Donald
1 Primary Care Clinical Unit, The University of Queensland Faculty of Medicine, Brisbane, Australia
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  • For correspondence: m.donald@uq.edu.au
Riitta Partanen
2 Rural Clinical School, The University of Queensland Faculty of Medicine, Hervey Bay, United Kingdom
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Leah Sharman
3 School of Psychology, The University of Queensland - Saint Lucia Campus, Saint Lucia, Australia
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Johanna Lynch
1 Primary Care Clinical Unit, The University of Queensland Faculty of Medicine, Brisbane, Australia
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Genevieve A Dingle
3 School of Psychology, The University of Queensland - Saint Lucia Campus, Saint Lucia, Australia
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Catherine Haslam
3 School of Psychology, The University of Queensland - Saint Lucia Campus, Saint Lucia, Australia
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Mieke van Driel
1 Primary Care Clinical Unit, The University of Queensland Faculty of Medicine, Brisbane, Australia
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Abstract

Background: There is considerable concern about increasing antidepressant use, with Australians among the highest users in the world. Evidence suggests this is driven by patients on long-term rather than new prescriptions. Most antidepressant prescriptions are generated in general practice and it is likely that attempts to discontinue are either not occurring or are proving unsuccessful. Aim: To explore GPs’ insights about long-term antidepressant prescribing. Design and Setting: A qualitative interview study with Australian GPs. Method: Semi-structured interviews explored GPs’ discontinuation experiences, decision-making, perceived risks and benefits, and support for patients. Data were analysed using reflexive thematic analysis. Results: Three overarching themes were identified from interviews with 22 GPs. The first, ‘Not a simple deprescribing decision’, speaks to the complex decision-making GPs undertake in determining whether a patient is ready to discontinue. The second, ‘A journey taken together’ captures a set of steps GPs take together with their patients to initiate and set-up adequate support before, during and after discontinuation. The third: ‘Supporting change in GPs’ prescribing practices’ describes what GPs would like to see change to better support them and their patients to discontinue antidepressants. Conclusions: GPs see discontinuation of long-term antidepressant use as more than a simple deprescribing decision. It begins with considering a patients’ social and relational context and is a journey involving careful preparation, tailored care and regular review. These insights suggest interventions to redress long-term use will need to take these considerations into account and be placed in a wider discussion about the use of antidepressants.

  • Mental health
  • Depression
  • Clinical (general)
  • Prescribing
  • Received October 7, 2020.
  • Accepted January 6, 2021.
  • Copyright © 2020, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
GPs’ insights about discontinuing long-term antidepressant use: a qualitative study
Maria Donald, Riitta Partanen, Leah Sharman, Johanna Lynch, Genevieve A Dingle, Catherine Haslam, Mieke van Driel
British Journal of General Practice 17 January 2021; BJGP.2020.0913. DOI: 10.3399/BJGP.2020.0913

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Accepted Manuscript
GPs’ insights about discontinuing long-term antidepressant use: a qualitative study
Maria Donald, Riitta Partanen, Leah Sharman, Johanna Lynch, Genevieve A Dingle, Catherine Haslam, Mieke van Driel
British Journal of General Practice 17 January 2021; BJGP.2020.0913. DOI: 10.3399/BJGP.2020.0913
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Keywords

  • Mental health
  • Depression
  • Clinical (general)
  • Prescribing

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Print ISSN: 0960-1643
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