Why do general practitioners prescribe antidepressants to their patients? A pilot study
Identifieur interne : 000312 ( Main/Exploration ); précédent : 000311; suivant : 000313Why do general practitioners prescribe antidepressants to their patients? A pilot study
Auteurs : Alain Mercier [France] ; Isabelle Auger-Aubin [France] ; Jean-Pierre Lebeau [France] ; Matthieu Schuers [France] ; Pascal Boulet [France] ; Paul Van Royen [Belgique] ; Lieve Peremans [Belgique]Source :
- Biopsychosocial Medicine [ 1751-0759 ] ; 2014.
Abstract
The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs’.
During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP.
The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems.
AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.
Url:
DOI: 10.1186/1751-0759-8-17
PubMed: 25110516
PubMed Central: 4126991
Affiliations:
- Belgique, France
- Haute-Normandie, Province d'Anvers, Région Normandie, Région de Bruxelles-Capitale
- Anvers, Bruxelles, Paris, Rouen, Tours
- Université d'Anvers
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general practitioners prescribe antidepressants to their patients? A pilot study</title><author><name sortKey="Mercier, Alain" sort="Mercier, Alain" uniqKey="Mercier A" first="Alain" last="Mercier">Alain Mercier</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I6">Department of Family practice, Rouen University, Faculty of Medicine, 20 Bd Gambetta, Rouen 76000, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Family practice, Rouen University, Faculty of Medicine, 20 Bd Gambetta, Rouen 76000</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName></affiliation></author><author><name sortKey="Auger Aubin, Isabelle" sort="Auger Aubin, Isabelle" uniqKey="Auger Aubin I" first="Isabelle" last="Auger-Aubin">Isabelle Auger-Aubin</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of General Practice, Denis Diderot Paris 7 University, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Denis Diderot Paris 7 University, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Lebeau, Jean Pierre" sort="Lebeau, Jean Pierre" uniqKey="Lebeau J" first="Jean-Pierre" last="Lebeau">Jean-Pierre Lebeau</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of General Practice, Tours University, Tours, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Tours University, Tours</wicri:regionArea><placeName><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Schuers, Matthieu" sort="Schuers, Matthieu" uniqKey="Schuers M" first="Matthieu" last="Schuers">Matthieu Schuers</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Boulet, Pascal" sort="Boulet, Pascal" uniqKey="Boulet P" first="Pascal" last="Boulet">Pascal Boulet</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Rouen University and CIC Inserm 0204, University of Rouen, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Van Royen, Paul" sort="Van Royen, Paul" uniqKey="Van Royen P" first="Paul" last="Van Royen">Paul Van Royen</name><affiliation wicri:level="4"><nlm:aff id="I4">Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Science, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Peremans, Lieve" sort="Peremans, Lieve" uniqKey="Peremans L" first="Lieve" last="Peremans">Lieve Peremans</name><affiliation wicri:level="4"><nlm:aff id="I4">Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Science, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="I5">Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Public Health, Vrije Universiteit Brussel, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author></analytic><series><title level="j">Biopsychosocial Medicine</title><idno type="eISSN">1751-0759</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs’.</p></sec><sec><title>Methods</title><p>During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP.</p></sec><sec><title>Results</title><p>The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems.</p></sec><sec><title>Conclusion</title><p>AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lepine, J P" uniqKey="Lepine J">J-P Lépine</name></author><author><name sortKey="Gasquet, I" uniqKey="Gasquet I">I Gasquet</name></author><author><name sortKey="Kovess, V" uniqKey="Kovess V">V Kovess</name></author><author><name sortKey="Arbabzadeh Bouchez, S" uniqKey="Arbabzadeh Bouchez S">S Arbabzadeh-Bouchez</name></author><author><name sortKey="Negre Pages, L" uniqKey="Negre Pages L">L Nègre-Pagès</name></author><author><name sortKey="Nachbaur, G" uniqKey="Nachbaur G">G Nachbaur</name></author><author><name sortKey="Gaudin, A F" uniqKey="Gaudin A">A-F Gaudin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Olie, Jp" uniqKey="Olie J">JP Olié</name></author><author><name sortKey="Elomari, F" uniqKey="Elomari F">F Elomari</name></author><author><name sortKey="Spadone, C" 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Manzoli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Der Wouden, Jc" uniqKey="Van Der Wouden J">JC Van der Wouden</name></author><author><name sortKey="Blankenstein, Ah" uniqKey="Blankenstein A">AH Blankenstein</name></author><author><name sortKey="Huibers, Mjh" uniqKey="Huibers M">MJH Huibers</name></author><author><name sortKey="Van Der Windt, Dawm" uniqKey="Van Der Windt D">DAWM van der Windt</name></author><author><name sortKey="Stalman, Wab" uniqKey="Stalman W">WAB Stalman</name></author><author><name sortKey="Verhagen, Ap" uniqKey="Verhagen A">AP Verhagen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peen, J" uniqKey="Peen J">J Peen</name></author><author><name sortKey="Schoevers, Ra" uniqKey="Schoevers R">RA Schoevers</name></author><author><name sortKey="Beekman, At" uniqKey="Beekman A">AT Beekman</name></author><author><name sortKey="Dekker, J" uniqKey="Dekker J">J Dekker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sleath, B" uniqKey="Sleath B">B Sleath</name></author><author><name sortKey="Shih, Y Ct" uniqKey="Shih Y">Y-CT Shih</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Os, Tw" uniqKey="Van Os T">TW Van Os</name></author><author><name sortKey="Van Den Brink, Rh" uniqKey="Van Den Brink R">RH van den Brink</name></author><author><name sortKey="Tiemens, Bg" uniqKey="Tiemens B">BG Tiemens</name></author><author><name sortKey="Jenner, Ja" uniqKey="Jenner J">JA Jenner</name></author><author><name sortKey="Van Der Meer, K" uniqKey="Van Der Meer K">K van der Meer</name></author><author><name sortKey="Ormel, J" uniqKey="Ormel J">J Ormel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Patience, Da" uniqKey="Patience D">DA Patience</name></author><author><name sortKey="Mcguire, Rj" uniqKey="Mcguire R">RJ McGuire</name></author><author><name sortKey="Scott, Ai" uniqKey="Scott A">AI Scott</name></author><author><name sortKey="Freeman, Cp" uniqKey="Freeman C">CP Freeman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Horwitz, Av" uniqKey="Horwitz A">AV Horwitz</name></author><author><name sortKey="Wakefield, Jc" uniqKey="Wakefield J">JC Wakefield</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Belgique</li><li>France</li></country><region><li>Haute-Normandie</li><li>Province d'Anvers</li><li>Région Normandie</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Anvers</li><li>Bruxelles</li><li>Paris</li><li>Rouen</li><li>Tours</li></settlement><orgName><li>Université d'Anvers</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Mercier, Alain" sort="Mercier, Alain" uniqKey="Mercier A" first="Alain" last="Mercier">Alain Mercier</name></noRegion><name sortKey="Auger Aubin, Isabelle" sort="Auger Aubin, Isabelle" uniqKey="Auger Aubin I" first="Isabelle" last="Auger-Aubin">Isabelle Auger-Aubin</name><name sortKey="Boulet, Pascal" sort="Boulet, Pascal" uniqKey="Boulet P" first="Pascal" last="Boulet">Pascal Boulet</name><name sortKey="Lebeau, Jean Pierre" sort="Lebeau, Jean Pierre" uniqKey="Lebeau J" first="Jean-Pierre" last="Lebeau">Jean-Pierre Lebeau</name><name sortKey="Mercier, Alain" sort="Mercier, Alain" uniqKey="Mercier A" first="Alain" last="Mercier">Alain Mercier</name><name sortKey="Schuers, Matthieu" sort="Schuers, Matthieu" uniqKey="Schuers M" first="Matthieu" last="Schuers">Matthieu Schuers</name></country><country name="Belgique"><region name="Province d'Anvers"><name sortKey="Van Royen, Paul" sort="Van Royen, Paul" uniqKey="Van Royen P" first="Paul" last="Van Royen">Paul Van Royen</name></region><name sortKey="Peremans, Lieve" sort="Peremans, Lieve" uniqKey="Peremans L" first="Lieve" last="Peremans">Lieve Peremans</name><name sortKey="Peremans, Lieve" sort="Peremans, Lieve" uniqKey="Peremans L" first="Lieve" last="Peremans">Lieve Peremans</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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