An exploration of GP perspectives on deprescribing antidepressants: a
qualitative study
Abstract
Background: An understanding of deprescribing processes in primary care
is an important step in designing policy initiatives and healthcare
systems to optimise appropriate antidepressant discontinuation. Aim: To
explore GPs perceptions and experiences of discontinuing
antidepressants. Design and setting: Following ethical approval, a
qualitative study was undertaken with GPs affiliated with a University
education and research network for general practice in Ireland. Method:
Semi-structured interviews undertaken with a purposive sample of GPs
(n=10) between July 2019 and March 2020, were transcribed and analysed
using Braun and Clarkes (2013) thematic analysis framework. Results:
Five themes emerged: Clinical dilemmas; personalised therapy; medication
tapering toolkit; talk therapy and concerns around tapering. GPs
described being less likely to engage in deprescribing in those with
recurrent depression, older patients and those with comorbidities. Fear
associated with patient relapse was described by all participants. GPs
felt limited access to psychological services impacted on care and that
prompts to review might facilitate deprescribing. Conclusions: GPs are
confident in their role of managing mild to moderate depression in the
community and deprescribing antidepressants. This study provides an
insight into factors that influence GPs decisions to deprescribe
antidepressants and the barriers and facilitators for GPs in this role.