Imperial College London
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ProfessorThomasBarnes

Faculty of Medicine, Department of Brain Sciences

Emeritus Professor of Clinical Psychiatry
 
 
 
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Contact

 

t.r.barnes

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Paton:2020:10.1177/2045125320930492,
author = {Paton, C and Anderson, IM and Cowen, PJ and Delgado, O and Barnes, TRE},
doi = {10.1177/2045125320930492},
journal = {Therapeutic Advances in Psychopharmacology},
title = {Prescribing for moderate or severe unipolar depression in patients under the long-term care of UK adult mental health services},
url = {http://dx.doi.org/10.1177/2045125320930492},
volume = {10},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: A quality improvement programme addressing prescribing practice for depression was initiated by the Prescribing Observatory for Mental Health. Methods: A baseline clinical audit against evidence-based practice standards was conducted in UK adult mental health services. Results: 55 mental health services submitted data for 2082 patients, under the care of a community psychiatric team (CMHT) for at least a year, with a diagnosis of moderate or severe unipolar depression, 54% of whom had a comorbid psychiatric diagnosis. SSRIs were prescribed for 35% of the patients, other newer generation antidepressants for 60%, tricyclic antidepressants for 6% and MAOIs for <1%. The most commonly prescribed individual antidepressants were mirtazapine (33%, usually in combination with another antidepressant), venlafaxine (25%), and sertraline (21%). Patients with severe depression were more likely (p<0.001) to be co-prescribed an antipsychotic medication, lithium, or to have received ECT. There was a documented clinical review in the last year in 85%, with a symptom rating scale used in 11%. A documented comprehensive treatment history was accessible for 50% of those prescribed antidepressant medication. Conclusions: Patients with moderate or severe depression remaining under the care of a CMHT for longer than a year are clinically complex. The failure to achieve a level of wellness allowing discharge from mental health services may be partly related to the finding that not all patients had the benefit of a systematic approach to clinical assessment and sequential testing of available evidence-based pharmacological interventions. KeywordsDepression; antidepressant; quality improvement; mental health services; prescribing practice
AU  - Paton,C
AU  - Anderson,IM
AU  - Cowen,PJ
AU  - Delgado,O
AU  - Barnes,TRE
DO  - 10.1177/2045125320930492
PY  - 2020///
SN  - 2045-1253
TI  - Prescribing for moderate or severe unipolar depression in patients under the long-term care of UK adult mental health services
T2  - Therapeutic Advances in Psychopharmacology
UR  - http://dx.doi.org/10.1177/2045125320930492
UR  - http://hdl.handle.net/10044/1/78751
VL  - 10
ER  -
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