title: Improving Access to Psychological Therapies and antidepressant prescribing rates in England: a longitudinal time-series analysis.
abstract: BACKGROUND
  Antidepressant prescribing rates in England have been increasing since the 1970s. The impact of the Improving Access to Psychological Therapies (IAPT) initiative on antidepressant prescribing rates is unknown.
  
  
  OBJECTIVE
  To investigate the impact of the establishment of IAPT services on antidepressant prescribing rates in primary care trusts (PCTs) in England.
  
  
  METHODS
  A longitudinal time-series analysis, using PCT-level data from 2008 to 2011 set in England.
  
  
  METHODS
  A time-series analysis was conducted using PCT-level prescription data, dates of establishment of IAPT services, and covariate data for age, sex, and socioeconomic status. Statistical analysis was carried out using analysis of variance and a random-effect negative binomial model.
  
  
  RESULTS
  Antidepressant prescribing rates in England increased by 10% per year during the study period (adjusted rate ratio = 1.10, 95% CI = 1.09 to 1.10). The implementation of IAPT services had no significant effect on antidepressant prescribing (adjusted rate ratio = 0.99, 95% CI = 0.99 to 1.00).
  
  
  CONCLUSIONS
  Introduction of a large-scale initiative to increase provision of psychological therapies has not curbed the long-term increased prescribing of antidepressants in England.
authors.affiliation: Department of Primary Care and Public Health, Imperial College, London, Reynolds Building, Charing Cross Campus, London, UK. vaishnavee@doctors.org.uk
authors.forename: Vaishnavee
authors.initials: V
authors.lastname: Sreeharan
authors.forename: Hugo
authors.initials: H
authors.lastname: Madden
authors.forename: John Tayu
authors.initials: JT
authors.lastname: Lee
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000628:therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents