Why do general practitioners prescribe antidepressants to their patients? A pilot study

BioPsychoSocial Medicine

Alain Mercier⁴  Isabelle Auger-Aubin⁵  Jean-Pierre Lebeau⁶  Matthieu Schuers¹  Pascal Boulet¹  Paul Van Royen³  Lieve Peremans² 

[1] Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen, France

[2] Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium

[3] Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium

[4] Department of Family practice, Rouen University, Faculty of Medicine, 20 Bd Gambetta, Rouen 76000, France

[5] Department of General Practice, Denis Diderot Paris 7 University, Paris, France

[6] Department of General Practice, Tours University, Tours, France

关键词: Off label use;    Prescription;    General practitioner;    Primary care;    Antidepressants;   

Others  :  1082321
DOI  :  10.1186/1751-0759-8-17

 received in 2014-04-21, accepted in 2014-07-25,  发布年份 2014

【 摘 要 】

Background

The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs’.

Methods

During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP.

Results

The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems.

Conclusion

AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.

【 授权许可】

   
2014 Mercier et al.; licensee BioMed Central Ltd.

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