Evidence map›Paper›PMID 33985965›Full record

ArticleBJGP open2021

Trends and variation in antidepressant prescribing in English primary care: a retrospective longitudinal study.

Paul Bogowicz, Helen J Curtis, Alex J Walker, Philip Cowen, John Geddes, Ben Goldacre

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PubMed Full text at PMC Publisher
In one paragraph

Article in BJGP open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 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

37 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  8. Understanding antidepressant change patterns in the UK Biobank.The British journal of psychiatry : the journal of mental science · 2026
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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

6 authors.

Paul BogowiczPopulation Health Sciences Institute, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-5239-8829
Helen J CurtisThe DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Alex J WalkerThe DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-4932-6135
Philip CowenDepartment of Psychiatry, University of Oxford, Oxford, UK.
John GeddesDepartment of Psychiatry, University of Oxford, Oxford, UK.
Ben GoldacreThe DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK ben.goldacre@phc.ox.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntidepressants are commonly prescribed. There are clear national guidelines in relation to treatment sequencing. This study examines trends and variation in antidepressant prescribing across English primary care.

aimTo examine trends and variation in antidepressant prescribing in England, with a focus on: monoamine oxidase inhibitors (MAOIs); paroxetine; and dosulepin and trimipramine. DESIGN & SETTIN:

methodClass- and drug-specific proportions were calculated at national and practice levels. Descriptive statistics were generated, percentile charts and maps were plotted, and logistic regression analysis was conducted.

resultsAntidepressant prescriptions more than tripled between 1998 and 2018, from 377 items per 1000 population to 1266 per 1000. MAOI prescribing fell substantially, from 0.7% of all antidepressant items in 1998 to 0.1% in 2018. There was marked variation between practices in past year prescribing of paroxetine (median practice proportion [MPP] = 1.7%, interdecile range [IDR] = 2.6%) and dosulepin (MPP = 0.7%, IDR = 1.8%), but less for trimipramine (MPP = 0%, IDR = 0.2%).

conclusionRapid growth and substantial variation in antidepressant prescribing behaviour was found between practices. The causes could be explored using mixed-methods research. Interventions to reduce prescribing of specific antidepressants, such as dosulepin, could include review prompts, alerts at the time of prescribing, and clinician feedback through tools like OpenPrescribing.net.

Indexed as

antidepressive agentsprimary health carequality of health care

Identifiers

PMID33985965
PMCPMC8450889

What OpenQuestion holds

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LicenceCC BY
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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.