Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis

Br J Gen Pract. 2013 Sep;63(614):e649-53. doi: 10.3399/bjgp13X671641.

Abstract

Background: Antidepressant prescribing rates in England have been increasing since the 1970s. The impact of the Improving Access to Psychological Therapies (IAPT) initiative on antidepressant prescribing rates is unknown.

Aim: To investigate the impact of the establishment of IAPT services on antidepressant prescribing rates in primary care trusts (PCTs) in England.

Design and setting: A longitudinal time-series analysis, using PCT-level data from 2008 to 2011 set in England.

Method: A time-series analysis was conducted using PCT-level prescription data, dates of establishment of IAPT services, and covariate data for age, sex, and socioeconomic status. Statistical analysis was carried out using analysis of variance and a random-effect negative binomial model.

Results: Antidepressant prescribing rates in England increased by 10% per year during the study period (adjusted rate ratio = 1.10, 95% CI = 1.09 to 1.10). The implementation of IAPT services had no significant effect on antidepressant prescribing (adjusted rate ratio = 0.99, 95% CI = 0.99 to 1.00).

Conclusion: Introduction of a large-scale initiative to increase provision of psychological therapies has not curbed the long-term increased prescribing of antidepressants in England.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / statistics & numerical data*
  • Depressive Disorder / therapy*
  • Drug Prescriptions / statistics & numerical data
  • Female
  • General Practice / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data
  • Socioeconomic Factors
  • Young Adult

Substances

  • Antidepressive Agents