The Treatment of Depression: Prescribing Patterns of Antidepressants in Primary Care in the UK

1996 ◽  
Vol 168 (2) ◽  
pp. 164-168 ◽  
Author(s):  
J. M. Donoghue ◽  
A. Tylee
Keyword(s):  
Primary Care ◽  
Tricyclic Antidepressants ◽  
Data Sources ◽  
Prescribing Patterns ◽  
Prescribing Practices ◽  
Short Term ◽  
Treatment Of Depression ◽  
Educational Implications ◽  
Effective Doses ◽  
The Uk

BackgroundConsensus has been achieved about how depression should be treated in primary care, and guidelines have been issued by the Royal Colleges of General Practitioners and Psychiatrists, and by the British Association for Psychopharmacology. One of the principal recommendations is to prescribe antidepressant medicine at effective doses. This study was established to investigate how current prescribing practices in primary care compared with these guidelines.MethodInformation on prescribing of antidepressant medicines was obtained using three independent data sources: Prescribing Analysis and Cost (PACT) data; medical notes; and a large, computerised patient record database.ResultsData were obtained on populations in excess of 1.5 million people, and over 80 000 prescriptions were reviewed. All three data sources showed very similar patterns of prescribing, in particular that as many as 88% of prescriptions for older tricyclic antidepressants are prescribed by GPs at doses below those recommended by the consensus guidelines. Newer antidepressants – lofepramine and the SSRIs – are prescribed comparatively well.ConclusionsPrescribing of antidepressants by GPs is not in line with the consensus recommendations on dosage. This may have major educational implications for GPs. A pragmatic approach to improve prescribing in the short term may be to advocate the use of lofepramine or the SSRIs as first line treatment for depression. This study validates the use of PACT data as a useful audit tool in this area of clinical practice.

scholarly journals Identifying antibiotic prescribing patterns through multi-level latent profile analyses: a cross-sectional survey of primary care physicians in Hubei of China

2020 ◽  
Author(s):  
Dan Wang ◽  
Chaojie Liu ◽  
Xinping Zhang ◽  
Chenxi Liu
Keyword(s):  
Primary Care ◽  
Broad Spectrum ◽  
Primary Care Physicians ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Latent Profile Analyses ◽  
Broad Spectrum Antibiotics

Abstract Background Overuse of antibiotics significantly fuels the development of AMR, which threating the global population health. Great variations existed in antibiotic prescribing practices among physicians, indicating improvement potential for rational use of antibiotics. This study aims to identify antibiotic prescribing patterns of primary care physicians and potential determinants. Methods A cross-sectional survey was conducted on 551 physicians from 67 primary care facilities in Hubei selected through random cluster sampling, tapping into their knowledge, attitudes and prescribing practices toward antibiotics. Prescriptions (n=501,072) made by the participants from 1 January to 31 March 2018 were extracted from the medical records system. Seven indicators were calculated for each prescriber: average number of medicines per prescription, average number of antibiotics per prescription, percentage of prescriptions containing antibiotics, percentage of antibiotic prescriptions containing broad-spectrum antibiotics, percentage of antibiotic prescriptions containing parenteral administered antibiotics, percentage of antibiotic prescriptions containing restricted antibiotics, and percentage of antibiotic prescriptions containing antibiotics included in the WHO “Watch and Reserve” list. Two-level latent profile analyses were performed to identify the antibiotic prescribing patterns of physicians based on those indicators. Multi-nominal logistic regression models were established to identify determinants with the antibiotic prescribing patterns. Results On average, each primary care physician issued 909 (ranging from 100 to 11941 with a median of 474) prescriptions over the study period. The mean percentage of prescriptions containing antibiotics issued by the physicians reached 52.19% (SD=17.20%). Of those antibiotic prescriptions, an average of 82.29% (SD=15.83%) contained broad-spectrum antibiotics; 71.92% (SD=21.42%) contained parenteral administered antibiotics; 23.52% (SD=19.12%) contained antibiotics restricted by the regional government; and 67.74% (SD=20.98%) contained antibiotics listed in the WHO “Watch and Reserve” list. About 28.49% of the prescribers were identified as low antibiotic users, compared with 51.18% medium users and 20.33% high users. Higher use of antibiotics was associated with insufficient knowledge, indifference to changes, complacency with satisfied patients, low household income and rural location of the prescribers. Conclusion Great variation in antibiotic prescribing patterns exists among primary care physicians in Hubei of China. High use of antibiotics is not only associated with knowledge shortfalls but also low socioeconomic status of prescribers.

Compliance with antidepressant treatment of depression in primary care in the UK

1998 ◽  
Vol 8 ◽  
pp. S202-S203 ◽  
Author(s):  
J. McKendrick ◽  
D.A. Stephenson ◽  
C. Thompson ◽  
R.C. Peveler
Keyword(s):  
Primary Care ◽  
Antidepressant Treatment ◽  
Treatment Of Depression ◽  
The Uk

The psychopharmacological treatment of depression in primary care in the Royal Navy

2014 ◽  
Vol 100 (2) ◽  
pp. 193-201
Author(s):  
RH Coetzee
Keyword(s):  
Primary Care ◽  
Clinical Information ◽  
Armed Forces ◽  
Health Condition ◽  
Second Line ◽  
Mental Health Condition ◽  
Royal Navy ◽  
Psychopharmacological Treatment ◽  
Treatment Of Depression ◽  
The Uk

AbstractDepression is a common mental health condition in the UK Armed Forces. Although psychopharmacology is usually a second line intervention, there is a place for antidepressants in the management of depression in primary care. This article will examine the diagnosis of depression, the indications for starting antidepressants, the choice of anti-depressants and the occupational considerations in the Royal Navy. The aim is to equip General Practitioners (GPs) and General Duties Medical Officers (GDMOs) with the clinical information needed to initiate psychopharmacological treatment for depression where indicated.

scholarly journals Management of COPD in the UK primary-care setting: an analysis of real-life prescribing patterns

2014 ◽  
pp. 889 ◽  
Author(s):  
David Price ◽  
Daniel West ◽  
Guy Brusselle ◽  
Kevin Gruffydd-Jones ◽  
Rupert Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Real Life ◽  
Prescribing Patterns ◽  
The Uk

scholarly journals Identifying Antibiotic Prescribing Patterns Through Multi-Level Latent Profile Analyses: A Cross-Sectional Survey of Primary Care Physicians

2020 ◽  
Vol 11 ◽  
Author(s):  
Dan Wang ◽  
Chaojie Liu ◽  
Xinping Zhang ◽  
Chenxi Liu
Keyword(s):  
Primary Care ◽  
Broad Spectrum ◽  
Primary Care Physicians ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Latent Profile Analyses ◽  
Broad Spectrum Antibiotics

Background: Overuse of antibiotics significantly fuels the development of Antimicrobial resistance, which threating the global population health. Great variations existed in antibiotic prescribing practices among physicians, indicating improvement potential for rational use of antibiotics. This study aims to identify antibiotic prescribing patterns of primary care physicians and potential determinants.Methods: A cross-sectional survey was conducted on 551 physicians from 67 primary care facilities in Hubei selected through random cluster sampling, tapping into their knowledge, attitudes and prescribing practices toward antibiotics. Prescriptions (n = 501,072) made by the participants from 1 January to March 31, 2018 were extracted from the medical records system. Seven indicators were calculated for each prescriber: average number of medicines per prescription, average number of antibiotics per prescription, percentage of prescriptions containing antibiotics, percentage of antibiotic prescriptions containing broad-spectrum antibiotics, percentage of antibiotic prescriptions containing parenteral administered antibiotics, percentage of antibiotic prescriptions containing restricted antibiotics, and percentage of antibiotic prescriptions containing antibiotics included in the WHO “Watch and Reserve” list. Two-level latent profile analyses were performed to identify the antibiotic prescribing patterns of physicians based on those indicators. Multi-nominal logistic regression models were established to identify determinants with the antibiotic prescribing patterns.Results: On average, each primary care physician issued 909 (ranging from 100 to 11,941 with a median of 474) prescriptions over the study period. The mean percentage of prescriptions containing antibiotics issued by the physicians reached 52.19% (SD = 17.20%). Of those antibiotic prescriptions, an average of 82.29% (SD = 15.83%) contained broad-spectrum antibiotics; 71.92% (SD = 21.42%) contained parenteral administered antibiotics; 23.52% (SD = 19.12%) contained antibiotics restricted by the regional government; and 67.74% (SD = 20.98%) contained antibiotics listed in the WHO “Watch and Reserve” list. About 28.49% of the prescribers were identified as low antibiotic users, compared with 51.18% medium users and 20.33% high users. Higher use of antibiotics was associated with insufficient knowledge, indifference to changes, complacency with satisfied patients, low household income and rural location of the prescribers.Conclusion: Great variation in antibiotic prescribing patterns exists among primary care physicians in Hubei of China. High use of antibiotics is not only associated with knowledge shortfalls but also low socioeconomic status of prescribers.

scholarly journals Third sector provision of dementia support in the community: results from a scoping exercise of charity involvement in the UK

2021 ◽  
Author(s):  
Andrea M. Mayrhofer ◽  
Claire Goodman ◽  
Louise Lafortune ◽  
Nigel Smeeton ◽  
Brian Littlechild ◽  
...  
Keyword(s):  
Local Knowledge ◽  
Third Sector ◽  
Data Sources ◽  
Short Term ◽  
Local Data ◽  
Community Based ◽  
The Uk ◽  
Volunteer Engagement

Third sector dementia support is characterised by wide variation and a heavy reliance on volunteer engagement. While there has been a growth in the reach and diversity of different schemes, their short-term funding results in a loss of networks, collaborations and local knowledge. This practice paper reflects on strengthening community-based dementia support and care via public and third sector partnerships. National and local data sources could help charities and commissioners begin to identify inequalities of provision.

scholarly journals Are more men seeking help for erectile dysfunction? A time trend analysis

BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101145
Author(s):  
Colette Bell ◽  
Abdul Hadi Muhammad ◽  
Saval Khanal ◽  
Vibhu Paudyal
Keyword(s):  
Primary Care ◽  
Erectile Dysfunction ◽  
Fold Increase ◽  
Prescribing Patterns ◽  
Prescribing Practices ◽  
Regional Demography ◽  
Regional Deprivation ◽  
Seeking Help ◽  
Government Data ◽  
Deprived Areas

Background: Sildenafil and tadalafil are recommended first line treatment for Erectile Dysfunction (ED). Sildenafil was legally reclassified to a ‘pharmacy’ medicine in the United Kingdom in 2018. Aim: To assess the prescribing patterns and costs associated with prescribing of ED drugs in England and to investigate the link between prescribing and deprivation, regional demography and legal reclassification. Design and setting: Aanalysis of publicly available government data from various sources pertaining to primary care prescribing and demographics in England was conducted. Methods: Prescribing and cost data for the last 10 years (2009-2019) were extracted and adjusted for inflation, male populations and regional deprivation. Results: Between 2009 and 2019 the rate of prescribing, measured as the number of items per 1000 men, increased by 110%. In 2019, the rate of prescribing of ED medicines in the most deprived areas was 21.0% higher than the rate observed in least deprived areas. The Northern regions of England had approximately 50% higher rate of prescribing compared to London. A 0.5% annual increase in the number of prescription items was observed between 2018 and 2019, compared to 5.0% increase observed from 2017 to 2018. Conclusion: The two-fold increase in the rate of primary care prescriptions in the last 10 years suggests that more men are being screened for or seeking help for ED. Higher rate of prescribing offers opportunity for monitoring of linked risk factors such as diabetes mellitus, dyslipidaemia, and vascular disorders in deprived populations. Reclassification of sildenafil had a modest impact on prescribing practices.

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