Evidence map›Paper›PMID 33820792›Full record

ArticleBMJ open2021

Exploration of GP perspectives on deprescribing antidepressants: a qualitative study.

Dervla Kelly, Justin Graffi, Maria Noonan, Philip Green, John McFarland, Peter Hayes, Liam Glynn

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dervla KellySchool of Medicine and Health Research Institute Health Implementation Science Research Cluster, University of Limerick, Limerick, Ireland Dervla.M.Kelly@ul.ie.ORCID 0000-0001-9836-5400
Justin GraffiSchool of Medicine, University of Limerick, Limerick, Ireland.
Maria NoonanDepartment of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
Philip GreenSchool of Medicine, University of Limerick, Limerick, Ireland.
John McFarlandSchool of Medicine and Department of Psychiatry, University of Limerick, Limerick, Ireland.
Peter HayesSchool of Medicine, University of Limerick, Limerick, Ireland.
Liam GlynnSchool of Medicine, University of Limerick, Limerick, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOur aim was to explore general practitioners' (GPs) perceptions and experiences of discontinuing antidepressants. STUDY

designA qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a thematic analysis framework.

settingGPs affiliated with a university education and research network for general practice in Ireland.

participantsA purposive sample of GPs (n=10).

resultsFive themes emerged: shared decision-making; personalised therapy; medication-tapering toolkit; health service factors and concerns around tapering. GPs described being less likely to engage in deprescribing for patients with long-term and/or recurrent depression, older patients and those with comorbidities due to fear of relapse. Access to evidence-based psychological therapies, guidelines, information on rates of relapse, patient leaflets on discontinuing antidepressants and reminder prompts on GP-prescribing software were suggested to optimise appropriate antidepressant discontinuation. There was some suggestion that patients may use antidepressants for longer when talk therapy is not available or taken up.

conclusionsGPs are largely confident in their role of managing mild-to-moderate depression and deprescribing antidepressants. This study provides an insight into factors that influence GPs' decisions to deprescribe antidepressants. More information on rates of relapse after discontinuation would be helpful to inform decision-making.

Indexed as

DeprescriptionsGeneral PractitionersAntidepressive AgentsAttitude of Health PersonnelHumansIrelandQualitative ResearchAntidepressive Agentsdepression & mood disordersprimary carequalitative researchquality in healthcare

Identifiers

PMID33820792
PMCPMC8030471

What OpenQuestion holds

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Registered trials

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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.