GPs prescribe lower volumes of antidepressants
in areas with more Black or South Asian people, suggesting possible
disparities in the provision of care.
The study,
published in the September issue of the British Journal of
Psychiatry, also reveals that higher volumes of
antidepressants are prescribed by general practices in economically
deprived areas, and by practices serving areas with a high
prevalence of chronic illness.
Researchers from King’s College London set out
to explore the relationship between physical illness, social
deprivation, ethnicity, practice characteristics and the volume of
antidepressants prescribed in primary care.
They used data derived from the Quality and
Outcomes Framework, a system established in 2004 which gives
financial incentives to GPs for achieving certain performance
targets. Prescribing data for antidepressant medicines were
collected from national Prescribing Analyses and CosT data for
2004-2005. Ethnicity and deprivation data were provided by the
Informatics Collaboratory of the Social Sciences.
Analysis showed that the greatest predictors
of the volume of antidepressants prescribed were social
deprivation, the prevalence of chronic illness (asthma, chronic
obstructive pulmonary disease (COPD) and epilepsy) and ethnic
density.
Overall, socio-economic status, ethnic
density, asthma, COPD and epilepsy explained 44% of the variance in
the volume of antidepressants prescribed.
The researchers claim that more
antidepressants are prescribed in socio-economically deprived areas
because of higher levels of depression in these areas.
Chronic illness is also associated with higher
rates of depression, which may account for the increased volumes of
prescriptions in practices with a higher prevalence of these
illnesses.
Surprisingly, the way that GP surgeries are
organised and run did not seem to influence prescribing volumes.
The researchers had predicted that practices where appointments
last at least 10 minutes, and those which have a lower number of
patients per GP, would prescribe higher volumes of antidepressants
because cases of depression are more likely to be recognised.
However, organisational factors appeared to have little influence
on the volumes of antidepressants prescribed.
The study’s authors say that further research
is now needed to determine the clinical impact of these variations
in antidepressant prescribing.