ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Appropriateness of antidepressant prescribing: an observational study in a Scottish primary-care setting.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Frequent attenders in late life in primary care: a systematic review of European studies.BMC family practice · 2017Pooled it
- Does cycle commuting reduce the risk of mental ill-health? An instrumental variable analysis using distance to nearest cycle path.International journal of epidemiology · 2024Article
- Use of sequence analysis for classifying individual antidepressant trajectories to monitor population mental health.BMC psychiatry · 2020Article
- Item bias detection in the Hospital Anxiety and Depression Scale using structural equation modeling: comparison with other item bias detection methods.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2017Article
- Explaining the variation between practices in the duration of new antidepressant treatment: a database cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Patient factors associated with SSRI dose for depression treatment in general practice: a primary care cross sectional study.BMC family practice · 2014Article
- A comparison of three methods of assessing differential item functioning (DIF) in the Hospital Anxiety Depression Scale: ordinal logistic regression, Rasch analysis and the Mantel chi-square procedure.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2014Article
- Gender differences in general and specialty outpatient mental health service use for depression.BMC psychiatry · 2014Article
- Stepped care for depression is easy to recommend, but harder to implement: results of an explorative study within primary care in the Netherlands.BMC family practice · 2014Article
- An end to depression in primary care?The British journal of general practice : the journal of the Royal College of General Practitioners · 2012Article
- Assessment of mental disorders using the patient health questionnaire as a general screening tool in western Nigeria: A community-based study.Journal of neurosciences in rural practice · 2012Article
- Antidepressants utilization among elderly in Lombardy from 2000 to 2007: dispensing trends and appropriateness.European journal of clinical pharmacology · 2011Article
- Prescribing safety: the case of inappropriate medicines.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- Most antidepressant use in primary care is justified; results of the Netherlands Study of Depression and Anxiety.PloS one · 2011Article
- Antidepressant prescribing.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Why do GPs prescribe psychotropic drugs when they would rather provide alternative psychological interventions?The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Antidepressant prescribing for older adults.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Antidepressant prescribing for older adults.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Antidepressant prescribing.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
- 'A coal face option': GPs' perspectives on the rise in antidepressant prescribing.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince the 1990s, Scottish community-based antidepressant prescribing has increased substantially.
aimTo assess whether GPs prescribe antidepressants appropriately. DESIGN OF STUDY: Observational study of adults (aged >/=16 years) screened with the Hospital Anxiety and Depression Scale (HADS) attending a GP.
settingFour practices in Grampian, Scotland.
methodPatients (n = 898) completed the HADS, and GPs independently estimated depression status. Notes were scrutinised for evidence of antidepressant use, and the appropriateness of prescribing was assessed.
resultsA total of 237 (26%) participants had HADS scores indicating 'possible' (15%) or 'probable' (11%) depression. The proportion of participants rated as depressed by their GP differed significantly by HADS depression subscale scores. Odds ratio for 'possible' versus 'no' depression was 3.54 (95% confidence interval [CI] = 2.17 to 5.76, P<0.001); and for 'probable' versus 'possible' depression was 3.59 (95% CI = 2.06 to 6.26, P<0.001). Similarly, the proportion of participants receiving antidepressants differed significantly by HADS score. Odds ratio for 'possible' versus 'no' depression was 2.79 (95% CI = 1.70 to 4.58, P<0.001); and for 'probable' versus 'possible' was 2.12 (95% CI = 1.21 to 3.70, P = 0.009). In 101 participants with 'probable' depression, GPs recognised 53 (52%) participants as having a clinically significant depression. Inappropriate initiation of antidepressant treatment occurred very infrequently. Prescribing to participants who were not symptomatic was accounted for by the treatment of pain, anxiety, or relapse prevention, and for ongoing treatment of previously identified depression.
conclusionThere was little evidence of prescribing without relevant indication. Around half of patients with significant symptoms were not identified by their GP as suffering from a depressive disorder: this varied inversely with severity ratings. Rather than prescribing indiscriminately (as has been widely assumed), it is likely that GPs are initiating antidepressant treatment conservatively.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.