DIFFERENCE IN ANTI-DEPRESSANT PRESCRIBING TRENDS BETWEEN GENERAL
PRACTITIONERS AND PSYCHIATRIC SPECIALISTS
Deborah Camilleri, Anthony Serracino-Inglott, Lilian M. Azzopardi
Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
email: debbiecamilleri7@gmail.com
DEPARTMENT OF PHARM
ACY
UNIVERSI
TY OF MA
LTA
Department of Pharmacy
University of Malta
INTRODUCTION
AIMS
Antidepressants have nowadays become one of the most widely
To carry out an extensive analysis on current prescribing practices
used prescription drugs worldwide.
1
Pharmacist interventions in
among psychiatrists and general practitioners in the treatment of
patients with mental illness have been evaluated and demonstrate
major depression and to determine adherence to guidelines.
that a collaborative care approach involving pharmacists may be
To investigate current perception of the role of the pharmacist in
correlated with multiple beneficial outcomes. 2
this field and to make proposals for improvement.
METHOD
RESULTS
Feedback was obtained from 64 GPs and 18 psychiatrists. The mean
rating scores provided for each statement between psychiatrists and GPs
were compared. The score ranges from 0-4, where 0 corresponds to
never and 4 corresponds to very often. Figure 1 demonstrates how SSRIs
are the most popular choice [score 3.42-3.61], followed by SNRIs [score
1.77-2.33] and TCAs [score 1.34-1.78]. Paroxetine is the most commonly
prescribed SSRI, with a score > 3 in both sample groups. Significant
Figure 1. Clustered bar graph showing how often each antidepressant class is
prescribed as a first-line agent in the treatment of major depression
differences in the prescribing of fluoxetine and fluvoxamine were found,
with p values < 0.05. 33 GPs said they “often” prescribe antidepressants
as a repeat prescription, whereas 22 said they “very often” do so. Figure
2 illustrates how 88% of psychiatrists practicing within a hospital setting
would find the availability of a clinical pharmacist “very useful”.
Figure 2. Pie chart illustrating psychiatrists’
perception of clinical pharmacist interventions
(n=18)
CONCLUSION
The prevalence of depression is steadily on the increase and has a significant impact on the quality of life of patients. Outcomes in psychiatric therapy can be improved
through the adoption of a more collaborative and multidisciplinary approach. 3 Analysis of results indicate that psychiatrists who practice within a hospital setting would
find the availability of a clinical pharmacist ‘very useful’ leading to less polypharmacy and drug interactions as well as optimized treatment regimes.
Reference(s) 1. Moore M et al. Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. BMJ 2009; 339: b3999.
2. Finley PR, Crimson ML, Rush J. Evaluating the Impact of Pharmacists in Mental Health: A Systematic Review. Pharmacotherapy 2003; 23(12): 1634-1644.
3. Katon W et al. Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA 1995; 273(13): 1026-1031.