Evidence map›Paper›PMID 34269688›Full record

ArticleJournal of medical Internet research2021

A Digital Intervention for Primary Care Practitioners to Support Antidepressant Discontinuation (Advisor for Health Professionals): Development Study.

Hannah Bowers, Tony Kendrick, Nadja van Ginneken, Marta Glowacka, Samantha Williams, Geraldine M Leydon, Carl May, Christopher Dowrick, Joanna Moncrieff, Chris F Johnson and 3 more

Open access · goldAbstract read
In one paragraph

Article in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 42% of its field
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
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

13 authors at 6 institutions in 1 country.

Hannah BowersPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0002-1996-6652
Tony KendrickPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0003-1618-9381
Nadja van GinnekenDepartment of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.ORCID 0000-0002-4843-2617
Marta GlowackaFaculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom.ORCID 0000-0002-7792-9980
Samantha WilliamsPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0001-9505-6485
Geraldine M LeydonPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0001-5986-3300
Carl MayDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.ORCID 0000-0002-0451-2690
Christopher DowrickDepartment of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.ORCID 0000-0002-4245-2203
Joanna MoncrieffDivision of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.ORCID 0000-0003-1214-6974
Chris F JohnsonPharmacy & Prescribing Support Unit, Pharmacy Services, NHS Greater Glasgow & Clyde, Glasgow, United Kingdom.ORCID 0000-0002-6006-6605
Michael MoorePrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0002-5127-4509
Rebecca LainePrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0002-5039-113X
Adam W A GeraghtyPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.ORCID 0000-0001-7984-8351
University of Southampton · GBUniversity of Liverpool · GBBournemouth University · GBFaculty (United Kingdom) · GBLondon School of Hygiene & Tropical Medicine · GBNHS Greater Glasgow and Clyde · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe number of people receiving antidepressants has increased in the past 3 decades, mainly because of people staying on them longer. However, in many cases long-term treatment is not evidence based and risks increasing side effects. Additionally, prompting general practitioners (GPs) to review medication does not improve the rate of appropriate discontinuation. Therefore, GPs and other health professionals may need help to support patients discontinuing antidepressants in primary care.

objectiveThis study aims to develop a digital intervention to support practitioners in helping patients discontinue inappropriate long-term antidepressants (as part of a wider intervention package including a patient digital intervention and patient telephone support).

methodsA prototype digital intervention called Advisor for Health Professionals (ADvisor HP) was planned and developed using theory, evidence, and a person-based approach. The following elements informed development: a literature review and qualitative synthesis, an in-depth qualitative study, the development of guiding principles for design elements, and theoretical behavioral analyses. The intervention was then optimized through think-aloud qualitative interviews with health professionals while they were using the prototype intervention.

resultsThink-aloud qualitative interviews with 19 health professionals suggested that the digital intervention contained useful information and was readily accessible to practitioners. The development work highlighted a need for further guidance on drug tapering schedules for practitioners and clarity about who is responsible for broaching the subject of discontinuation. Practitioners highlighted the need to have information in easily and quickly accessible formats because of time constraints in day-to-day practice. Some GPs felt that some information was already known to them but understood why this was included. Practitioners differed in their ideas about how they would use ADvisor HP in practice, with some preferring to read the resource in its entirety and others wanting to dip in and out as needed. Changes were made to the wording and structure of the intervention in response to the feedback provided.

conclusionsADvisor HP is a digital intervention that has been developed using theory, evidence, and a person-based approach. The optimization work suggests that practitioners may find this tool to be useful in supporting the reduction of long-term antidepressant use. Further quantitative and qualitative evaluation through a randomized controlled trial is needed to examine the feasibility, effectiveness, and cost-effectiveness of the intervention.

Indexed as

Antidepressive AgentsGeneral PractitionersCost-Benefit AnalysisHumansPrimary Health CareQualitative ResearchAntidepressive Agentsantidepressant discontinuationdepressiondigital interventionintervention developmentprimary care

Identifiers

PMID34269688
PMCPMC8325079
OpenAlexW3159782417

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.