A Digital Intervention for Primary Care Practitioners to Support Antidepressant Discontinuation (Advisor for Health...

Area of Science:

• Digital health interventions
• Primary care medicine
• Pharmacotherapy

Background:

• Antidepressant use has risen over 30 years, with many patients remaining on medication long-term.
• Long-term antidepressant treatment is often not evidence-based and increases side effect risks.
• Current methods to prompt medication review do not effectively support appropriate discontinuation by general practitioners (GPs).

Purpose of the Study:

• To develop a digital intervention (ADvisor HP) to aid health professionals in assisting patients with discontinuing inappropriate long-term antidepressant use.
• To integrate this tool within a broader intervention package, including patient-focused digital support and telephone assistance.

Main Methods:

• Developed a prototype digital intervention (ADvisor HP) using a theory- and evidence-based, person-centered approach.
• Informed development through literature reviews, qualitative synthesis, and in-depth qualitative studies.
• Optimized the intervention via think-aloud qualitative interviews with 19 health professionals.

Main Results:

• Health professionals found ADvisor HP useful and accessible, providing valuable information.
• Identified needs for enhanced guidance on drug tapering schedules and clarity on initiating discontinuation discussions.
• Practitioners emphasized the need for easily accessible information formats due to time constraints.

Conclusions:

• ADvisor HP is a theory- and evidence-based digital tool developed to support antidepressant discontinuation.
• Optimization suggests potential utility for practitioners in reducing long-term antidepressant use.
• Further randomized controlled trials are necessary to evaluate feasibility, effectiveness, and cost-effectiveness.