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


CONCLUSIONS
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.
Badger
Frances
F
School of Health Sciences, University of Birmingham, Birmingham, UK. f.j.badger@bham.ac.uk
Nolan
Peter
P
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D002983:Clinical Competence; D000529:Complementary Therapies / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000517:prevention & control / Q000523:psychology; D004739:England; D019317:Evidence-Based Medicine; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D004366:Nonprescription Drugs