Enhancing shared decision making about discontinuation of antidepressant medication: A concept-mapping study in primary and secondary mental health care

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Publication year
2019Author(s)
Number of pages
9 p.
Source
British Journal of General Practice, 69, 688, (2019), pp. e777-e785ISSN
Publication type
Article / Letter to editor

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Organization
Psychiatry
Primary and Community Care
Internal Medicine
Pharmacology-Toxicology
SW OZ BSI KLP
Journal title
British Journal of General Practice
Volume
vol. 69
Issue
iss. 688
Languages used
English (eng)
Page start
p. e777
Page end
p. e785
Subject
All institutes and research themes of the Radboud University Medical Center; Experimental Psychopathology and Treatment; Radboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health SciencesAbstract
Background: The apparent rise of antidepressant use seems to be explained to a large extent by an increase in long-term use. Both professionals and patients appear reluctant to discontinue antidepressant medication (ADM). It is not known what factors determine this reluctance. Aim: This study aimed to identify factors that enable the shared decision-making process about discontinuation of ADM between long-term users and their GPs. Design and setting: Concept-mapping study of a purposive sample of both patients and professionals from primary and secondary mental health care in the Netherlands. Method: Concept mapping was used to conceptualise and structure the topics relevant to the discontinuation process from the perspective of both patients and professionals. Participants generated topics in brainstorming sessions and subsequently prioritised and sorted them. Multidimensional scaling and hierarchical cluster analyses were used for the cluster topics. Results: Thirty-seven patients and 27 professionals generated 50 separate topics. Hierarchical cluster analysis revealed six clusters of topics: 'Process of discontinuation', 'Expectations', 'Professional guidance', 'Current use', 'Environment', and 'Side effects'. Patients and professionals came up with largely similar topics. Nevertheless, a difference was found between these groups regarding the perceived importance of professional guidance. Conclusion: This study yielded an informed selection of the topics that seem most important to discuss when considering whether to discontinue ADM. As perspectives of both patients and professionals were combined, the topics may provide patients and GPs with a broader and more balanced scope of factors to consider, and thus facilitate a better shared decision-making process.
This item appears in the following Collection(s)
- Academic publications [227881]
- Electronic publications [107344]
- Faculty of Medical Sciences [86219]
- Faculty of Social Sciences [28471]
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