BACKGROUND: Studies on antidepressant prescriptions in general practice need to assess the level of prescriptions relative to the need for them ('coverage'), and the variability among doctors. METHODS: Two different cut-off scores on a screening test for depression (the Personal Health Questionnaire, PHQ) are used to predict rates for depression, and rates for depressive patients thought likely to benefit from antidepressants (according to a severity criterion) in primary care patients. These two rates are compared with assessments by 11 GPs of recognised depression, as well as with rates of drug prescribed. RESULTS: The rate for depression thought likely to be treated with antidepressants estimated with the PHQ is broadly comparable with the rate for conspicuous depressive illness, and much lower than that predicted by the PHQ for depression. There was great variability between GPs in their ability to detect depression, and their preparedness to prescribe antidepressants. Antidepressants were only prescribed for 3.5% of the patients, compared to the 8.9% thought to need them. However, antidepressants, mostly SSRIs, are much more likely to be prescribed than tranquillisers. LIMITATIONS: The limitations of the study are that the PHQ is able to estimate 'coverage' but not 'focusing' (the proportion of those receiving antidepressants who needed them). CONCLUSIONS: Although the rate for conspicuous depression is similar to that for depressions thought to be treated with antidepressants, the 'coverage' of antidepressants was only 39.3%. The variability between physicians confirm the need of good practice guidelines and training packages for the identification and management of depression. Large epidemiological studies are needed to overcome the current lack of clinically relevant data on the quality of antidepressant prescriptions in general practice.
BACKGROUND: Studies on antidepressant prescriptions in general practice need to assess the level of prescriptions relative to the need for them ('coverage'), and the variability among doctors. METHODS: Two different cut-off scores on a screening test for depression (the Personal Health Questionnaire, PHQ) are used to predict rates for depression, and rates for depressivepatients thought likely to benefit from antidepressants (according to a severity criterion) in primary care patients. These two rates are compared with assessments by 11 GPs of recognised depression, as well as with rates of drug prescribed. RESULTS: The rate for depression thought likely to be treated with antidepressants estimated with the PHQ is broadly comparable with the rate for conspicuous depressive illness, and much lower than that predicted by the PHQ for depression. There was great variability between GPs in their ability to detect depression, and their preparedness to prescribe antidepressants. Antidepressants were only prescribed for 3.5% of the patients, compared to the 8.9% thought to need them. However, antidepressants, mostly SSRIs, are much more likely to be prescribed than tranquillisers. LIMITATIONS: The limitations of the study are that the PHQ is able to estimate 'coverage' but not 'focusing' (the proportion of those receiving antidepressants who needed them). CONCLUSIONS: Although the rate for conspicuous depression is similar to that for depressions thought to be treated with antidepressants, the 'coverage' of antidepressants was only 39.3%. The variability between physicians confirm the need of good practice guidelines and training packages for the identification and management of depression. Large epidemiological studies are needed to overcome the current lack of clinically relevant data on the quality of antidepressant prescriptions in general practice.
Authors: Claudia Vesel; Homa Rashidisabet; John Zulueta; Jonathan P Stange; Jennifer Duffecy; Faraz Hussain; Andrea Piscitello; John Bark; Scott A Langenecker; Shannon Young; Erin Mounts; Larsson Omberg; Peter C Nelson; Raeanne C Moore; Dave Koziol; Keith Bourne; Casey C Bennett; Olusola Ajilore; Alexander P Demos; Alex Leow Journal: J Am Med Inform Assoc Date: 2020-07-01 Impact factor: 4.497
Authors: Monica Cepoiu; Jane McCusker; Martin G Cole; Maida Sewitch; Eric Belzile; Antonio Ciampi Journal: J Gen Intern Med Date: 2007-10-26 Impact factor: 5.128
Authors: Mauro Giovanni Carta; Eugenio Aguglia; Alberto Bocchetta; Matteo Balestrieri; Filippo Caraci; Massimo Casacchia; Liliana Dell'osso; Guido Di Sciascio; Filippo Drago; Carlo Faravelli; Maria Efisia Lecca; Maria Francesca Moro; Pier Luigi Morosini; Marcello Nardini; Gabriella Palumbo; Maria Carolina Hardoy Journal: Clin Pract Epidemiol Ment Health Date: 2010-08-27
Authors: Rebecca Strawbridge; Paul McCrone; Andrea Ulrichsen; Roland Zahn; Jonas Eberhard; Danuta Wasserman; Paolo Brambilla; Giandomenico Schiena; Ulrich Hegerl; Judit Balazs; Jose Caldas de Almeida; Ana Antunes; Spyridon Baltzis; Vladimir Carli; Vinciane Quoidbach; Patrice Boyer; Allan H Young Journal: Eur Psychiatry Date: 2022-06-15 Impact factor: 7.156