Consensus has been achieved about how depression should be treated in primary care, and guidelines have been issued by the Royal Colleges of General Practitioners and Psychiatrists, and by the British Association for Psychopharmacology.
One of the principal recommendations is to prescribe antidepressant medicine at effective doses.
This study was established to investigate how current prescribing practices in primary care compared with these guidelines.
Information on prescribing of antidepressant medicines was obtained using three independent data sources :
Prescribing Analysis and Cost (PACT) data ;
medical notes ;
and a large, computerised patient record database.
Data were obtained on populations in excess of 1.5 million people, and over 80 000 prescriptions were reviewed.
All three data sources showed very similar patterns of prescribing, in particular that as many as 88% of prescriptions for older tricyclic antidepressants are prescribed by GPs at doses below those recommended by the consensus guidelines.
Newer antidepressants - lofepramine and the SSRIs - are prescribed comparatively well.
Prescribing of antidepressants by GPs is not in line with the consensus recommendations on dosage.
This may have major educational implications for GPs.
A pragmatic approach to improve prescribing in the short term may be to advocate the use of lofepramine or the SSRIs as first line treatment for depression.
This study val...
Mots-clés Pascal : Etat dépressif, Trouble humeur, Prescription médicale, Chimiothérapie, Traitement, Antidépresseur, Psychotrope, Epidémiologie, Royaume Uni, Europe, Soin santé primaire, Médecin généraliste, Santé publique, Homme, Personnel sanitaire
Mots-clés Pascal anglais : Depression, Mood disorder, Medical prescription, Chemotherapy, Treatment, Antidepressant agent, Psychotropic, Epidemiology, United Kingdom, Europe, Primary health care, General practitioner, Human, Health staff
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0144566
Code Inist : 002B02B02. Création : 199608.