The monitoring of longer term prescriptions of antidepressants: observational study in a primary care setting.
BACKGROUND
There is little evidence to guide the frequency of review for patients taking antidepressants in the longer term.


OBJECTIVE
To measure the frequency with which patients on longer term courses of antidepressants have their treatment monitored in primary care and to identify patient characteristics associated with the frequency of monitoring.


METHODS
A cohort of patients who were receiving antidepressants continuously for at least two years was identified from four general practices. Data were collected from patients' general medical records. The dates of all GP consultations and whether they included a documented review of antidepressant therapy were recorded, along with patient characteristics hypothesized to influence the frequency of monitoring.


RESULTS
The frequency of antidepressant review consultations and proportion of participants being reviewed during a specific year of antidepressant therapy decreased with increasing year of antidepressant therapy. Individuals who receive antidepressants for an overt mental health reason; undergo more dose and drug changes; and who are referred to the community mental health team have their antidepressant therapy reviewed more often during the first five years of antidepressant therapy.


CONCLUSIONS
As many patients on longer term courses of antidepressants are not being appropriately reviewed, a 'chronic disease management approach' to depression in primary care is advocated.
School of Medicine and Dentistry.
Jennifer E
JE
Sinclair
Division of Applied Health Sciences.
Lorna S
LS
Aucott
Centre of Academic Primary care, Division of Applied Health Sciences and.
Kenneth
K
Lawton
Psychiatry Group, Division of Applied Medicine, University of Aberdeen, Aberdeen, UK.
Ian C
IC
Reid
Psychiatry Group, Division of Applied Medicine, University of Aberdeen, Aberdeen, UK. i.m.cameron@abdn.ac.uk.
Isobel M
IM
Cameron
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy; D003863:Depression / Q000188:drug therapy*; D017723:Drug Utilization Review; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012606:Scotland
D000928:Antidepressive Agents
Antidepressive agents; drug monitoring; general practice; long-term care; primary health care.