Healthcare Providers' Perspectives on Antidepressant Discontinuation: A Focus Group Study

Abstract

Antidepressant (AD) discontinuation in long-term users can be challenging for both patients and healthcare providers (HCPs). Better understanding of how HCPs handle this challenge is needed to improve discontinuation care. Therefore, we identified AD discontinuation barriers and facilitators from the viewpoint of community pharmacists (CPs), general practitioners (GPs), psychiatrists and nurse practitioners and explored their views on their specific roles in AD discontinuation. Two focus group discussions involving four GPs, six pharmacists and three psychiatrists and one interview with a nurse practitioner were performed. Discussions were recorded and transcribed verbatim. Directed content analysis was performed using the theoretical domains framework. Six themes were identified: identification of patients, behaviour of HCPs regarding AD discontinuation, fears and emotions, context and resources, knowledge, evidence and skills and professional attitude. All HCPs stressed the importance of raising awareness for AD discontinuation. Barriers included fear of recurrence or discontinuation symptoms, poor collaboration between HCPs and lack of resources. Facilitators included the availability of tools and guidelines. HCPs were unaware and uncertain about each other's roles and responsibilities and showed motivation to provide guidance. This requires professional collaboration agreements and sufficient resources. Experienced CPs may contribute by identifying AD users and providing information/support.

Keywords: antidepressant; depression; discontinuation; general practice; healthcare providers; qualitative research.