Initiation of antidepressant therapy: do patients follow the GP's prescription?
- 1 February 2009
- journal article
- Published by Royal College of General Practitioners in British Journal of General Practice
- Vol. 59 (559), 81-87
- https://doi.org/10.3399/bjgp09X395067
Abstract
The question whether patients actually start drug taking after having received a first antidepressant prescription is often overlooked. To determine the incidence of patients who do not fill or fill only a single antidepressant prescription at the pharmacy, and to identify associated patient characteristics. Retrospective study linking a general practice to a pharmacy dispensing database. General practice in the Netherlands. patients who received a first-time antidepressant prescription from a GP. Three patient groups were identified: patients who did not fill the prescription (non-fillers); patients who filled only a single prescription (single Rx-fillers); and patients who filled at least two consecutive prescriptions. Non-fillers and single Rx-fillers were combined into a group of decliners. Of all 965 patients, 41 (4.2%) did not fill the prescription, and 229 (23.7%) filled only a single prescription. Patients who consulted their GP for a non-specific indication, rather than for depression, anxiety, panic, or obsessive-compulsive disorder, were almost three times more likely (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.8 to 3.9) to decline treatment. Further, the risk of declining was almost fivefold higher (OR = 4.8, 95% CI = 2.1 to 11.3) in non-Western immigrants, and almost twofold higher (OR = 1.8, 95% CI = 1.2 to 2.8) in patients >60 years of age. Over one in four patients who receive a first-time antidepressant prescription decline treatment; they either do not initiate drug taking or do not persist with antidepressant use for longer than 2 weeks.This publication has 37 references indexed in Scilit:
- Help-seeking preferences for psychological distress in primary care:British Journal of General Practice, 2008
- The care of patients with subthreshold depression in primary care: Is it all that bad? A qualitative study on the views of general practitioners and patientsBMC Health Services Research, 2007
- Patient risk profiles and practice variation in nonadherence to antidepressants, antihypertensives and oral hypoglycemicsBMC Health Services Research, 2007
- Monitoring health inequalities through general practice: the Second Dutch National Survey of General PracticeEuropean Journal of Public Health, 2005
- Early discontinuation of antidepressants in general practice: association with patient and prescriber characteristicsFamily Practice, 2004
- Patients' preferences in the treatment of depressive disorder in primary careGeneral Hospital Psychiatry, 2004
- Prescriber Intent, Off-Label Usage, and Early Discontinuation of AntidepressantsPublished by Physicians Postgraduate Press, Inc ,2004
- Mild depression in general practice: time for a rethink?Drug and Therapeutics Bulletin, 2003
- Medication compliance in mood disorders relevance of the Health Belief Model and other determinantsPrimary Care Psychiatry, 2000
- Do patients cash prescriptions?BMJ, 1982