title: Maintenance use of antidepressants in Dutch general practice: non-guideline concordant.
abstract: BACKGROUND
  There is hardly evidence on maintenance treatment with antidepressants in primary care. Nevertheless, depression guidelines recommend maintenance treatment i.e. treatment to prevent recurrences, in patients with high risk of recurrence, and many patients use maintenance treatment with antidepressants. This study explores the characteristics of patients on maintenance treatment with antidepressants in general practice, and compares these characteristics with guideline recommendations for maintenance treatment.
  
  
  METHODS
  We used data (baseline, two-year and four-year follow-up) of primary care respondents with remitted depressive disorder (≥6 months) from the Netherlands Study of Depression and Anxiety (n = 776). Maintenance treatment was defined as the use of an antidepressant for ≥12 months. Multilevel logistic regression was used to describe the association between sociodemographic, clinical and care characteristics and use of maintenance treatment with antidepressants.
  
  
  RESULTS
  Older patients, patients with a lower education, those using benzodiazepines or receiving psychological/psychiatric care and patients with a concurrent history of a dysthymic or anxiety disorder more often received maintenance treatment with antidepressants.
  
  
  CONCLUSIONS
  Measurements were not made at the start of an episode, but at predetermined points in time. Diagnoses were based on interview (CIDI) data and could therefore in some cases have been different from the GP diagnosis.
  
  
  CONCLUSIONS
  Since patients with chronic or recurrent depression do not use maintenance treatment with antidepressants more often, characteristics of patients on maintenance treatment do not fully correspond with guideline recommendations. However, patients on maintenance treatment appear to be those with more severe disorder and/or more comorbidity.
authors.affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Piek
authors.affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Kollen
authors.affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Klaas
authors.initials: K
authors.lastname: van der Meer
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003710:Demography; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D060046:Maintenance Chemotherapy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data
chemical_list: D000928:Antidepressive Agents