A qualitative study into how guidelines facilitate general practitioners to empower women to make decisions regarding antidepressant use in pregnancy

McCauley, Claire-Odile; Casson, Karen

doi:10.1080/14623730.2013.781872

Cited by 9 publications

(47 citation statements)

References 37 publications

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“…21,22 Studies have shown that psychological interventions delivered in primary care are effective in reducing depressive symptomatology, [51][52][53] but in the UK at least, GPs report having few avenues to refer women for timely non-pharmacological treatment. 54 In our findings, antidepressant medication was the primary method of treatment in pregnancy, although there was some evidence that antidepressant medications were stopped during pregnancy, with few non-pharmacological alternatives being offered, which could lead to a significant risk of relapse. 55 Postnatally, GPs favored a range of treatments, endorsing both medication and psychological therapies for depression, with a smaller number reporting that they would refer to other mental health specialists and support groups.…”

Section: Effective Treatmentmentioning

confidence: 89%

“…GPs described prescribing anti-depressants in the absence of other options, 54 but women are often reluctant to take them if pregnant or breastfeeding, 56 which could impact on adherence to treatment. In real world primary care settings, the rate of complete recovery from depression is low, at around 30% following antidepressant treatment and slightly higher following psychological interventions.…”

Section: Effective Treatmentmentioning

confidence: 99%

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Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

Ford

Shakespeare

Elias

et al. 2016

FAMPRJ

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Section: Effective Treatmentmentioning

confidence: 89%

Section: Effective Treatmentmentioning

confidence: 99%

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

Ford

Shakespeare

Elias

et al. 2016

FAMPRJ

View full text Add to dashboard Cite

show abstract

“… A qualitative study into how guidelines facilitate general practitioners to empower women to make decisions regarding antidepressant use in pregnancy. McCauley and Casson (2013), Northern Ireland [ 33 ]. To develop an in-depth understanding of GPs’ experience of using guidelines in the treatment of perinatal depression and if this enabled them to empower women to become involved in treatment decisions.…”

Section: Methodsmentioning

confidence: 99%

Family physicians perceived role in perinatal mental health: an integrative review

et al. 2018

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BackgroundResponding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family physicians are ideally placed to provide an effective response as it is recognised that they are responsible for organising care and supports for women and their families. This paper reports an integrative review undertaken to examine family physicians’ perceived role in perinatal mental health care and concludes with recommendations for health policy, research and practice.MethodA systematic search of literature in seven databases from January 2000 to March 2016 identified a total of 1125 articles. Qualitative, quantitative and mixed-method studies were eligible for inclusion if they explored family physicians’ experiences of caring for women who experience perinatal mental health problems.ResultsThirteen articles reporting 11 studies met the inclusion criteria for this review and quality of included studies were assessed using published criteria for the critical appraisal of qualitative and quantitative research methods. Cross-study narrative syntheses of quantitative and qualitative findings are presented under three themes: identification of perinatal mental health problems, management of perinatal mental health problems and barriers to care provision. While family physicians recognise their role in relation to perinatal mental health the collective interpretation revealed that; they receive variable levels of preparation for this role, no consistent approach to screening exists, pharmacological management of mood disorders is the main treatment modality and limited access to specialist perinatal mental health services exists which impacts on pharmacology decisions.ConclusionFamily physicians require timely access to local integrated care pathways that provide a wide range of services that are culturally sensitive, perinatal mental health specific, support psychological well-being and infant/family mental health. Family physicians are open to incorporating a brief validated screening tool into primary practice supported by succinct guidelines. Research that examines training needs in relation to perinatal mental health could be used to inform family physician training programmes and curriculum development around perinatal mental health.

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“…While this approach was considered generally beneficial, it also raised its own issues: "It's quite time consuming from the GP's point of view that you end up seeing them much more often than you would if they weren't on medication" (30). GPs acknowledged they relied on using medication, together with seeing the patient regularly, more frequently than was ideal due to a lack of other treatment options: "I mean, it's best if it's a multiple approach rather than just drugs.…”

Section: Care and Managementmentioning

confidence: 99%

“…Three papers, reporting on depression only, used interviews to elicit GPs' views (28)(29)(30). One paper reported content analysis of open questions in a survey (31) and the fifth, (32) a non-peer reviewed report, covered perinatal mental health more generally.…”

Section: Studiesmentioning

confidence: 99%

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies

et al. 2017

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management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies. British Journal of General Practice, 67(661), e538-e546. doi: 10.3399/bjgp17X691889 This is the accepted version of the paper.This version of the publication may differ from the final published version. Background: Up to 20% of women experience anxiety and depression during the perinatal period. In Permanent

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A qualitative study into how guidelines facilitate general practitioners to empower women to make decisions regarding antidepressant use in pregnancy

Cited by 9 publications

References 37 publications

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review

Family physicians perceived role in perinatal mental health: an integrative review

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies

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