‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants
Background Long-term antidepressant use, much longer than recommended by guidelines, can harm patients and generate unnecessary costs. Most antidepressants are prescribed by general practitioners (GPs) but it remains unclear why they do not discontinue long-term use. Aim To explore GPs’ views and ex...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-10-01
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| Series: | Scandinavian Journal of Primary Health Care |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/02813432.2021.2006487 |
| _version_ | 1798034238395645952 |
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| author | Van Leeuwen Ellen Sibyl Anthierens Mieke L. van Driel An De Sutter Evelien van den Branden Thierry Christiaens |
| author_facet | Van Leeuwen Ellen Sibyl Anthierens Mieke L. van Driel An De Sutter Evelien van den Branden Thierry Christiaens |
| author_sort | Van Leeuwen Ellen |
| collection | DOAJ |
| description | Background Long-term antidepressant use, much longer than recommended by guidelines, can harm patients and generate unnecessary costs. Most antidepressants are prescribed by general practitioners (GPs) but it remains unclear why they do not discontinue long-term use. Aim To explore GPs’ views and experiences of discontinuing long-term antidepressants, barriers and facilitators of discontinuation and required support. Design and setting Qualitative study in Belgian GPs. Method 20 semi-structured face-to-face interviews with GPs. Interviews were analysed thematically. Results The first theme, ‘Success stories’ describes three strong motivators to discontinue antidepressants: patient health issues, patient requests and a new positive life event. Second, not all GPs consider long-term antidepressant use a ‘problem’ as they perceive antidepressants as effective and safe. GPs’ main concern is the risk of relapse. Third, GPs foresee that discontinuation of antidepressants is not an easy and straightforward process. GPs weigh up whether they have the necessary skills and whether it is worth the effort to start this process. Conclusion Discontinuation of long-term antidepressants is a difficult and uncertain process for GPs, especially in the absence of a facilitating life-event or patient demand. The absence of a compelling need for discontinuation and fear of relapse of symptoms in a stable patient are important barriers for GPs when considering discontinuation. In order to increase GPs’ motivation to discontinue long-term antidepressants, more emphasis on the futility of the actual effect and on potential harms related to long-term use is needed.KEY POINTS Current awareness: Long-term antidepressant use, much longer than recommended by guidelines, can harm patients and generate unnecessary costs. Main statements: • Discontinuation of long-term antidepressants is a difficult and uncertain process for GPs. • More emphasis on the futility of the actual effect of antidepressants and on potential harms related to long-term use is needed. |
| first_indexed | 2024-04-11T20:41:36Z |
| format | Article |
| id | doaj.art-586bf51ad3414196afa72c778204d9b2 |
| institution | Directory Open Access Journal |
| issn | 0281-3432 1502-7724 |
| language | English |
| last_indexed | 2024-04-11T20:41:36Z |
| publishDate | 2021-10-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj.art-586bf51ad3414196afa72c778204d9b22022-12-22T04:04:12ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242021-10-0139453354210.1080/02813432.2021.20064872006487‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressantsVan Leeuwen Ellen0Sibyl Anthierens1Mieke L. van Driel2An De Sutter3Evelien van den Branden4Thierry Christiaens5Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent UniversityFamily Medicine and Population, Health University of AntwerpFaculty of Medicine, Primary Care Clinical Unit, University of QueenslandDepartment of Family Medicine and Primary Health Care, Ghent UniversityGeneral practice “Het Spoor”Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences, Ghent UniversityBackground Long-term antidepressant use, much longer than recommended by guidelines, can harm patients and generate unnecessary costs. Most antidepressants are prescribed by general practitioners (GPs) but it remains unclear why they do not discontinue long-term use. Aim To explore GPs’ views and experiences of discontinuing long-term antidepressants, barriers and facilitators of discontinuation and required support. Design and setting Qualitative study in Belgian GPs. Method 20 semi-structured face-to-face interviews with GPs. Interviews were analysed thematically. Results The first theme, ‘Success stories’ describes three strong motivators to discontinue antidepressants: patient health issues, patient requests and a new positive life event. Second, not all GPs consider long-term antidepressant use a ‘problem’ as they perceive antidepressants as effective and safe. GPs’ main concern is the risk of relapse. Third, GPs foresee that discontinuation of antidepressants is not an easy and straightforward process. GPs weigh up whether they have the necessary skills and whether it is worth the effort to start this process. Conclusion Discontinuation of long-term antidepressants is a difficult and uncertain process for GPs, especially in the absence of a facilitating life-event or patient demand. The absence of a compelling need for discontinuation and fear of relapse of symptoms in a stable patient are important barriers for GPs when considering discontinuation. In order to increase GPs’ motivation to discontinue long-term antidepressants, more emphasis on the futility of the actual effect and on potential harms related to long-term use is needed.KEY POINTS Current awareness: Long-term antidepressant use, much longer than recommended by guidelines, can harm patients and generate unnecessary costs. Main statements: • Discontinuation of long-term antidepressants is a difficult and uncertain process for GPs. • More emphasis on the futility of the actual effect of antidepressants and on potential harms related to long-term use is needed.http://dx.doi.org/10.1080/02813432.2021.2006487mental healthantidepressantslong-term usediscontinuationqualitative researchgeneral practitioner |
| spellingShingle | Van Leeuwen Ellen Sibyl Anthierens Mieke L. van Driel An De Sutter Evelien van den Branden Thierry Christiaens ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants Scandinavian Journal of Primary Health Care mental health antidepressants long-term use discontinuation qualitative research general practitioner |
| title | ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants |
| title_full | ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants |
| title_fullStr | ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants |
| title_full_unstemmed | ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants |
| title_short | ‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants |
| title_sort | never change a winning team gps perspectives on discontinuation of long term antidepressants |
| topic | mental health antidepressants long-term use discontinuation qualitative research general practitioner |
| url | http://dx.doi.org/10.1080/02813432.2021.2006487 |
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