Use of self-chosen therapies by depressed people in primary care.

AIMS: This paper focuses on attitudes towards and use of self-chosen treatment among people prescribed antidepressants and discusses the implications for practitioners involved in medicines management.
BACKGROUND: In the wide-ranging debate around the extension of non-medical prescribing in the UK the relationship between complementary and alternative therapies and prescribed medication has received little attention. Research indicates that self-treatment, including use of complementary and alternative therapies is burgeoning, yet there is uncertainty about the degree to which practitioners should be knowledgeable about therapies or be capable of advising clients on their use. Complementary and alternative therapy use is common among people with depression and greater knowledge of their use may be appropriate if health practitioners are to be able to support and inform people with depressive symptoms.
METHODS: Qualitative methodology was adopted and 60 people from four primary care practices in the West Midlands, UK were interviewed individually and their self-reported treatment journeys documented.
RESULTS: Almost two-thirds of participants had attempted to use self-chosen therapies during their recent illness though few had discussed their use with health service practitioners. Use of a range of self-chosen therapies was supported by a belief that they were natural, combined with a desire to avoid consulting health practitioners. Reasons for non-use of such therapies included confidence in health practitioners and caution about the possibility of drug interactions.
CONCLUSIONS: Health practitioners require an awareness that people with mental health problems are using a range of self-chosen treatments and might consider the appropriateness of initiating discussions on self-chosen treatments with clients. This area requires greater debate and if necessary identification of an appropriate knowledge base. RELEVANCE TO CLINICAL PRACTICE: Assessment of common mental health problems should include discussion of patients' previous and current self-treatment. Such discussions will assist in identifying attitudes and beliefs towards health service treatment and provide a basis for selecting appropriate interventions.