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Antidepressant prescriptions and the effects of mental health nurses: an observational study from 2011-2015.

Magnée, T., Beurs, D.P. de, Schellevis, F.G., Verhaak, P.F. Antidepressant prescriptions and the effects of mental health nurses: an observational study from 2011-2015. Scandinavian Journal of Primary Health Care: 2018, 36(1), 47-55
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Purpose
The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses .Antidepressant prescriptions are very common in general practice, but are often not in line I with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication.

Material and methods
Anonymised data from the medical records of general practices participating in the NIVEL Primary Care Database in 2011–2015 were analysed in an observational study. We used multilevel logistic regression analyses to determine whether total antidepressant prescriptions and antidepressants prescribed within one week of diagnosing anxiety or depression decreased in the period 2011–2015. We analysed whether changes in antidepressant prescriptions were associated with the employment or consultation of mental health nurses.

Results
Antidepressants were prescribed in 30.3% of all anxiety or depression episodes; about half were prescribed within the first week. Antidepressants prescriptions for anxiety or depression increased slightly in the period 2011–2015. The employment of mental health nurses was not associated with a decreased number of prescriptions of antidepressants. Patients who had at least one mental health nurse consultation had fewer immediate prescriptions of antidepressants, but not fewer antidepressants in general.

Conclusions
Antidepressant prescriptions are still common in general practice. So far, the introduction of mental health nurses has not decreased antidepressant prescriptions, but it may have a postponing effect. (aut. ref.)