Maund, Emma; Dewar-Haggart, Rachel; Williams, Samantha; Bowers, Hannah; Geraghty, Adam WA; Leydon, Geraldine; May, Carl; Dawson, Sarah; Kendrick, Tony; (2018) Barriers and facilitators to discontinuing antidepressant use: A systematic review and thematic synthesis. Journal of affective disorders, 245. pp. 38-62. ISSN 0165-0327 DOI: https://doi.org/10.1016/j.jad.2018.10.107
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
OBJECTIVE: To explore patient and health professional views and experiences of antidepressant treatment with particular focus on barriers and facilitators to discontinuing use. DESIGN: Systematic review with thematic synthesis DATA SOURCES: MEDLINE, PubMed, Embase, PsycINFO, CINAHL, AMED, Health Management Information Consortium, OpenGrey, and the Networked Digital Library of Theses and Dissertations from inception until February 2017. Updated searches were carried out in July 2018. ELIGIBILITY CRITERIA: Primary studies, published in English, that used qualitative data collection and analysis, and had data on attitudes, beliefs, feelings, perceptions on continuing or discontinuing antidepressant use, of patients (aged 18 or above, who received treatment with antidepressants for at least 6 months) or any health professionals. DATA EXTRACTION: One reviewer extracted data and assessed study quality, which was checked by a second reviewer. FINDINGS: Twenty two papers were included in the review. A thematic synthesis was performed for patient perspectives only, due to insufficient data from a health professional perspective. The thematic synthesis yielded nine themes: (1) psychological and physical capabilities; (2) perception of antidepressants; (3) fears; (4) intrinsic motivators and goals; (5) the Doctor as a navigator to maintenance or discontinuation; (6) perceived cause of depression; (7) aspects of information that support decision-making; (8) significant others - a help or a hindrance; and (9) support from other health professionals. LIMITATIONS: Coding and development of subthemes and themes was performed by one researcher and further developed through discussion between two researchers. CONCLUSIONS: Barriers and facilitators to discontinuing antidepressant use are numerous and complex, and likely to require detailed conversations between patients and their general practitioners (GPs). These conversations are more likely to happen if GPs raise the issue of discontinuation. Further research from a health professional perspective including, but not limited to GPs, is needed.
Item Type | Article |
---|---|
Faculty and Department | Faculty of Public Health and Policy > Dept of Health Services Research and Policy |
PubMed ID | 30366236 |
Downloads
Filename: Maund 2018_Revised_main document.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
DownloadFilename: Maund 2018_Barriers and facilitators to discontinuing AD use_figures.docx
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
DownloadFilename: Maund 2018_Barriers and facilitators to discontinuing AD use_appendices.docx
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
Download