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Multicenter Study
. 2010 Apr;60(573):e144-55.
doi: 10.3399/bjgp10X483913.

Long-term prescribing of antidepressants in the older population: a qualitative study

Rebecca Dickinson  1 , Peter Knapp, Allan O House, Vandana Dimri, Arnold Zermansky, Duncan Petty, John Holmes, David K Raynor
Affiliations
Multicenter Study

Long-term prescribing of antidepressants in the older population: a qualitative study

Rebecca Dickinson et al. Br J Gen Pract. 2010 Apr.

Abstract

Background: High rates of long-term antidepressant prescribing have been identified in the older population.

Aims: To explore the attitudes of older patients and their GPs to taking long-term antidepressant therapy, and their accounts of the influences on long-term antidepressant use.

Design of study: Qualitative study using in-depth semi-structured interviews.

Setting: One primary care trust in North Bradford.

Method: Thirty-six patients aged > or =75 years and 10 GPs were interviewed. Patients were sampled to ensure diversity in age, sex, antidepressant type, and home circumstances.

Results: Participants perceived significant benefits and expressed little apprehension about taking long-term antidepressants, despite being aware of the psychological and social factors involved in onset and persistence of depression. Barriers to discontinuation were identified following four themes: pessimism about the course and curability of depression; negative expectations and experiences of ageing; medicine discontinuation perceived by patients as a threat to stability; and passive (therapeutic momentum) and active (therapeutic maintenance) decisions to accept the continuing need for medication.

Conclusion: There is concern at a public health level about high rates of long-term antidepressant prescribing, but no evidence was found of a drive for change either from the patients or the doctors interviewed. Any apprehension was more than balanced by attitudes and behaviours supporting continuation. These findings will need to be incorporated into the planning of interventions aimed at reducing long-term antidepressant prescribing in older people.

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Figures

Figure 1
Figure 1
Flow chart of recruitment from general practice database search to interview.
See this image and copyright information in PMC

References

    1. Petty D, House A, Knapp P, et al. Prevalence, duration and indications for prescribing of antidepressants in primary care. Age Ageing. 2006;35(5):523–526. - PubMed
    1. Beekman AT, Copeland JR, Prince MJ. Review of community prevalence of depression in later life. Br J Psychiatry. 1999;174:307–311. - PubMed
    1. Meltzer H, Gill B, Petticrew M, et al. Office of Population Census and Surveys (OPCS). Surveys of psychiatric morbidity in Great Britain report 1: The prevalence of psychiatric morbidity amongst adults living in private households. London: HMSO; 1995.
    1. Percudani M, Barbui C, Fortino, et al. Antidepressant drug prescribing among elderly subjects: population based study. Int J Geri Psych. 2005;20(2):113–118. - PubMed
    1. National Institute for Health and Clinical Excellence. Depression: management of depression in primary and secondary care — NICE guideline December 2004. London: NICE; 2004.

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