Prescribing ANtiDepressants Appropriately (PANDA): a cluster randomized controlled trial in primary care

BMC Family Practice

Study Protocol

Peter Verhaak¹  Peter Lucassen²  Esther Muskens²  Rhona Eveleigh²  Chris van Weel²  Anne Speckens³  Richard Oude Voshaar⁴  Jan Spijker⁵ 

[1] Department of Primary Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Netherlands Institute for health service research (NIVEL), Utrecht, The Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;University Center for Psychiatry & Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Trimbos Institute, Utrecht, The Netherlands;Behavorial Science institute, Radboud University Nijmegen, Nijmegen, The Netherlands;

关键词: Depression;    Anxiety;    Composite International Diagnostic Interview (CIDI);    Randomized controlled trial;    General practice;    Depressive disorder;    Anxiety disorders;   

DOI  :  10.1186/1471-2296-14-6

 received in 2012-08-06, accepted in 2012-12-18,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundInappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users.Methods/designWe have designed a cluster randomized controlled clinical trial to assess the (cost-) effectiveness of an antidepressant cessation advice in the absence of a proper indication for maintenance treatment with antidepressants in primary care.We will select all patients using antidepressants for over 9 months from 45 general practices. Patients will be diagnosed using the Composite International Diagnostic Interview (CIDI) version 3.0, extended with questions about the psychiatric history and previous treatment strategies. General practices will be randomized to either the intervention or the control group. In case of overtreatment, defined as the absence of a proper indication according to current guidelines, a cessation advice is given to the general practitioner. In the control groups no specific information is given. The primary outcome measure will be the proportion of patients that successfully discontinue their antidepressants at one-year follow-up. Secondary outcomes are dimensional measures of psychopathology and costs.DiscussionThis study protocol provides a detailed overview of the design of the trial. Study results will be of importance for refining current guidelines. If the intervention is effective it can be used in managed care programs.Trial registrationNTR2032

【 授权许可】

Unknown   
© Muskens et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.