RT Journal Article
SR Electronic
T1 Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e708
OP e719
DO 10.3399/bjgp16X686641
VO 66
IS 651
A1 Renske C Bosman
A1 Klaas M Huijbregts
A1 Peter FM Verhaak
A1 Henricus G Ruhé
A1 Harm WJ van Marwijk
A1 Anton JLM van Balkom
A1 Neeltje M Batelaan
YR 2016
UL http://bjgp.org/content/66/651/e708.abstract
AB Background Antidepressant use is often prolonged in patients with anxiety and/or depressive disorder(s) compared with recommendations in treatment guidelines to discontinue after sustained remission.Aim To unravel the motivations of patients and GPs causing long-term antidepressant use and to gain insight into possibilities to prevent unnecessary long-term use.Design and setting Qualitative study using semi-structured, in-depth interviews with patients and GPs in the Netherlands.Method Patients with anxiety and/or depressive disorder(s) (n = 38) and GPs (n = 26) were interviewed. Innovatively, the interplay between patients and their GPs was also investigated by means of patient–GP dyads (n = 20).Results The motives and barriers of patients and GPs to continue or discontinue antidepressants were related to the availability of supportive guidance during discontinuation, the personal circumstances of the patient, and considerations of the patient or GP. Importantly, dyads indicated a large variation in policies of general practices around long-term use and continuation or discontinuation of antidepressants. Dyads further indicated that patients and GPs seemed unaware of each other’s (mismatching) expectations regarding responsibility to initiate discussing continuation or discontinuation.Conclusion Although motives and barriers to antidepressant continuation or discontinuation were related to the same themes for patients and GPs, dyads indicated discrepancies between them. Discussion between patients and GPs about antidepressant use and continuation or discontinuation may help clarify mutual expectations and opinions. Agreements between a patient and their GP can be included in a patient-tailored treatment plan.