Understanding the prescription of antidepressants: a Qualitative study among French GPs

BMC Family Practice

Research Article

Isabelle Auger-Aubin¹  Alain Mercier²  Jean-Pierre Lebeau³  Paul Van Royen⁴  Lieve Peremans⁵ 

[1] Department of General Practice, Denis Diderot Paris 7 University, Paris, France;Department of General Practice, Rouen University and CIC Inserm 0204, Rouen University, Rouen, France;Department of General Practice, Tours University, Tours, France;Department of Primary and Interdisciplinary Care, Faculty of Medicine, University of Antwerp, Antwerp, Belgium;Department of Public Health, Vrije Universiteit of Brussels, Brussels, Belgium;

关键词: Focus Group;    Irritable Bowel Syndrome;    Primary Care Setting;    Major Depressive Episode;    Topic Guide;   

DOI  :  10.1186/1471-2296-12-99

 received in 2011-05-10, accepted in 2011-09-24,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundOne-tenth of France's population is prescribed at least one antidepressant, primarily by General Practitioners. The reasons for this high prescription rate remain unclear. One-third of these prescriptions may not comply with clinical practice guidelines, and 20% are potentially unrelated to any psychiatric condition. Our aim was to explore how GPs declare they use antidepressants in daily practice and understand their reasons for prescribing them.MethodSix focus groups including a total of 56 rural and urban GPs, with four interviews were performed. The topic guide focused on reasons for prescribing antidepressants in various primary care situations. Phenomenological analysis was performed by four researchers.ResultsAntidepressants were seen as useful and not harmful. Personal assessment based on experience and feeling determined the GPs' decisions rather than the use of scales. Twenty-four "non-psychiatric" conditions possibly leading to prescription of antidepressants in primary care were found.ConclusionsThe GPs reported prescribing antidepressants for a wide range of conditions other than depression. The GPs' decision making process is difficult and complex. They seemed to prefer to focus on their difficulties in diagnosing depression rather than on useless overtreatment. Instead of using the guidelines criteria to detect potential cases of useful prescription, physicians tend to use their own tools based on gut feelings, knowledge of the patient and contextual issues.

【 授权许可】

CC BY   
© Mercier et al; licensee BioMed Central Ltd. 2011