'A coal face option': GPs' perspectives on the rise in antidepressant prescribing

Macdonald, S.L. , Morrison, J.M., Maxwell, M., Munoz-Arroyo, R., Power, A., Smith, M., Sutton, M. and Wilson, P.M. (2009) 'A coal face option': GPs' perspectives on the rise in antidepressant prescribing. British Journal of General Practice, 59(566), pp. 658-659. (doi:10.3399/bjgp09X454106)

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Abstract

BACKGROUND Levels of antidepressant prescribing have dramatically increased in Western countries in the last two decades. AIM To explore GPs' views about, and explanations for, the increase in antidepressant prescribing in Scotland between 1995 and 2004. DESIGN Qualitative, interview study. SETTING General practices, Scotland. PARTICIPANTS GPs in 30 practices (n = 63) purposively selected to reflect a range of practice characteristics and levels of antidepressant prescribing. METHOD Interviews with GPs were taped and transcribed. Analysis followed a Framework Approach. RESULTS GPs offered a range of explanations for the rise in antidepressant prescribing in Scotland. Few doctors thought that the incidence of depression had increased, and many questioned the appropriateness of current levels of prescribing. A number of related factors were considered to have contributed to the increase. These included: the success of campaigns to raise awareness of depression; a willingness among patients to seek help; and the perceived safety of selective serotonin reuptake inhibitors, making it easier for GPs to manage depression in primary care. Many GPs believed that unhappiness, exacerbated by social deprivation and the breakdown of traditional social structures, was being `medicalised' inappropriately. CONCLUSION Most antidepressant prescriptions in Scotland are issued by GPs, and current policy aims to reduce levels of prescribing. To meet this aim, GPs' prescribing behaviour needs to change. The findings suggest that GPs see themselves as responders to, rather than facilitators of, change and this has obvious implications for initiatives to reduce prescribing.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wilson, Dr Philip and Morrison, Professor Jillian and Macdonald, Dr Sara
Authors: Macdonald, S.L., Morrison, J.M., Maxwell, M., Munoz-Arroyo, R., Power, A., Smith, M., Sutton, M., and Wilson, P.M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:British Journal of General Practice
Publisher:Royal College of General Practitioners
ISSN:0960-1643
ISSN (Online):1478-5242

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