What were Health Professionals’ perspectives of antidepressant discontinuation during the REDUCE trial?

Conference: 
SAPC ASM 2023 - Brighton
Talk Code: 
3B.6
Presenter: 
Hannah Bowers
Co-authors: 
Riya Tiwari, Catherine, Woods, Helen Page, Mahboobeh Sadeghi, Amy Din, Geraldine Leydon, Adam Geraghty, Tony Kendrick, on behalf of the REDUCE research team
Author institutions: 
University of Southampton

Problem

Antidepressant prescriptions are increasing and there is evidence that this increase is in part explained by patients continuing treatment long-term. Around 30-50% of patients taking antidepressants long-term may be able to stop taking them. The REDUCE programme developed an intervention package to support health professionals in tapering antidepressants. The intervention included an online resource for health professionals, an online resource for patients and three telephone support calls for patients. This was developed using evidence, theory and a person-based approach.

Approach

131 practices across England and Wales took part in the REDUCE trial, recruiting a total of 330 participants. Practices were randomised to the intervention arm or usual care. Health professionals in both arms of the trial were responsible for discussing antidepressant discontinuation with patients, tapering patients’ medication and reviewing patients as they discontinued. Twenty-seven health professionals were interviewed (23 GPs, 2 psychological wellbeing practitioners, 1 pharmacist, 1 mental health nurse). Interviews were transcribed and analysed using a thematic analysis.

Findings

The ongoing thematic analysis is exploring the health professionals’ perspectives of discontinuing antidepressants during the trial. The analysis aims to uncover perspectives on usual care well as views of the intervention package, processes through which the intervention may have worked, and how it could be implemented widely if effective.

Consequences

The findings of this study will explore views of the intervention package within the context of the randomised control trial. The findings will inform how the intervention, and primary care practice more generally, could be adapted to support health professionals in monitoring and tapering antidepressant medication. These findings will also shed light on how the developed intervention may be implemented in future, should it be effective.

Submitted by: 
Hannah Bowers
Funding acknowledgement: 
The study is funded by the National Institute for Health Research.