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Gold, incentives and meh

Huge variation in GP antidepressant prescribing

By Lilian Anekwe

An investigation into the prescribing of antidepressants in general practice has found there is more than a four-fold difference between the highest and lowest-prescribing GPs.

Prescriptions for antidepressants have hit record highs in recent years, despite a public and professional drive toward the use of psychological therapies.

The Government is thought to be keen to crackdown on GPs' over-reliance on antidepressants, and has gone some way to redress GPs' previous lack of treatment options by announcing an investment package to improve access to psychological therapies .

A study published in the February issue of the British Journal of General Practice studied the prescribing patterns of GPs in 983 practices in Scotland in 2005, and found a 4.6-fold difference between the highest and lowest deciles of antidepressant prescribing, with some practices prescribing at levels double the standardised rate of 6.77%.

The variation is lower than that found in similar studies, suggesting GPs have changed their prescribing habits in recent years. Previous research had found a 25-fold difference was found between 164 practices in East London, and an eight-fold difference was found between 61 practices in Cambridgeshire.

The researchers, from the University of Glasgow, also found almost half of the variation in antidepressants could be explained by socio-economic factors including deprivation, urban or rural location and list size. Single-handed GPs prescribed significantly fewer antidepressants than others.

Lead researcher Professor Jill Morrison, professor of primary care at the University of Glasgow, said it was important appropriate patients were not denied antidepressants because of a political agenda.

‘This is still a potentially worrying finding for policy-makers who expect an increase in the availability of psychological therapies to reduce prescribing levels of antidepressants.

‘It will be important to monitor the impact of this policy on the prescribing levels of antidepressants, and to ensure that some patients in already low-prescribing practices are not further disadvantaged because they do not receive appropriate treatment with antidepressants.'

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