Helping people discontinue long-term antidepressants: views of health professionals in UK primary care

Objective The aims of this paper were to identify, characterise and explain clinician factors that shape decision-making around antidepressant discontinuation in UK primary care.Design Four focus groups and three interviews were conducted and analysed using thematic analysis.Participants Twenty-one...

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Main Authors: Tony Kendrick, Geraldine Leydon, Carl R May, Hannah M Bowers, Adam W A Geraghty, Emma Maund, Wendy O’brien
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e027837.full
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author Tony Kendrick
Geraldine Leydon
Carl R May
Hannah M Bowers
Adam W A Geraghty
Emma Maund
Wendy O’brien
author_facet Tony Kendrick
Geraldine Leydon
Carl R May
Hannah M Bowers
Adam W A Geraghty
Emma Maund
Wendy O’brien
author_sort Tony Kendrick
collection DOAJ
description Objective The aims of this paper were to identify, characterise and explain clinician factors that shape decision-making around antidepressant discontinuation in UK primary care.Design Four focus groups and three interviews were conducted and analysed using thematic analysis.Participants Twenty-one general practitioners (GPs), four GP assistants, seven nurses and six community mental health team workers and psychotherapists took part in focus groups and interviews.Setting Participants were recruited from seven primary care regions and two National Health Service Trusts providing community mental health services in the South of England.Results Participants highlighted a number of barriers and enablers to discussing discontinuation with patients. They held a range of views around responsibility, with some suggesting it was the responsibility of the health professional (HP) to broach the subject, and others suggesting responsibility rested with the patients. HPs were concerned about destabilising the current situation, discussed how continuity and knowing the patient facilitated discontinuation talks, and discussed how confidence in their professional skills and knowledge affected whether they elected to raise discontinuation in consultations.Conclusions Findings indicate a need to consider support for HPs in the management of antidepressant medication and discussions of discontinuation in particular. They may also benefit from support around their fears of patient relapse and awareness of when and how to initiate discussions about discontinuation with their patients.
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spelling doaj-art-8d9945360b6b4df793f3394ccbfb47582024-11-23T20:30:09ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-027837Helping people discontinue long-term antidepressants: views of health professionals in UK primary careTony Kendrick0Geraldine Leydon1Carl R May2Hannah M Bowers3Adam W A Geraghty4Emma Maund5Wendy O’brien6Primary Care, Population Sciences and Medical Education, University of Southampton, Aldermoor Health Centre, Southampton, UKPrimary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK4 London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK1 Primary Care and Population Sciences, University of Southampton Faculty of Medicine, Southampton, UKSchool of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK1 Primary Care and Population Sciences, University of Southampton Faculty of Medicine, Southampton, UK1 Primary Care and Population Sciences, University of Southampton Faculty of Medicine, Southampton, UKObjective The aims of this paper were to identify, characterise and explain clinician factors that shape decision-making around antidepressant discontinuation in UK primary care.Design Four focus groups and three interviews were conducted and analysed using thematic analysis.Participants Twenty-one general practitioners (GPs), four GP assistants, seven nurses and six community mental health team workers and psychotherapists took part in focus groups and interviews.Setting Participants were recruited from seven primary care regions and two National Health Service Trusts providing community mental health services in the South of England.Results Participants highlighted a number of barriers and enablers to discussing discontinuation with patients. They held a range of views around responsibility, with some suggesting it was the responsibility of the health professional (HP) to broach the subject, and others suggesting responsibility rested with the patients. HPs were concerned about destabilising the current situation, discussed how continuity and knowing the patient facilitated discontinuation talks, and discussed how confidence in their professional skills and knowledge affected whether they elected to raise discontinuation in consultations.Conclusions Findings indicate a need to consider support for HPs in the management of antidepressant medication and discussions of discontinuation in particular. They may also benefit from support around their fears of patient relapse and awareness of when and how to initiate discussions about discontinuation with their patients.https://bmjopen.bmj.com/content/9/7/e027837.full
spellingShingle Tony Kendrick
Geraldine Leydon
Carl R May
Hannah M Bowers
Adam W A Geraghty
Emma Maund
Wendy O’brien
Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
BMJ Open
title Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
title_full Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
title_fullStr Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
title_full_unstemmed Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
title_short Helping people discontinue long-term antidepressants: views of health professionals in UK primary care
title_sort helping people discontinue long term antidepressants views of health professionals in uk primary care
url https://bmjopen.bmj.com/content/9/7/e027837.full
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