Bouarfa S, Göttgens Wilma, Ligthart Suzanne A, Maarsingh Otto R, Vinkers Christiaan H, Ruhé Henricus G, Bet Pierre M, Hugtenburg Jacqueline G
Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centre, Amsterdam, the Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Basic Clin Pharmacol Toxicol. 2025 Jun;137(1):e70051. doi: 10.1111/bcpt.70051.
Antidepressant (AD) discontinuation in long-term users can be challenging for both patients and healthcare providers (HCPs). Better understanding of how HCPs handle this challenge is needed to improve discontinuation care. Therefore, we identified AD discontinuation barriers and facilitators from the viewpoint of community pharmacists (CPs), general practitioners (GPs), psychiatrists and nurse practitioners and explored their views on their specific roles in AD discontinuation. Two focus group discussions involving four GPs, six pharmacists and three psychiatrists and one interview with a nurse practitioner were performed. Discussions were recorded and transcribed verbatim. Directed content analysis was performed using the theoretical domains framework. Six themes were identified: identification of patients, behaviour of HCPs regarding AD discontinuation, fears and emotions, context and resources, knowledge, evidence and skills and professional attitude. All HCPs stressed the importance of raising awareness for AD discontinuation. Barriers included fear of recurrence or discontinuation symptoms, poor collaboration between HCPs and lack of resources. Facilitators included the availability of tools and guidelines. HCPs were unaware and uncertain about each other's roles and responsibilities and showed motivation to provide guidance. This requires professional collaboration agreements and sufficient resources. Experienced CPs may contribute by identifying AD users and providing information/support.
对于长期服用抗抑郁药（AD）的患者而言，停用药物对患者和医疗服务提供者（HCPs）来说都颇具挑战。为了改善停药护理，需要更好地了解HCPs如何应对这一挑战。因此，我们从社区药剂师（CPs）、全科医生（GPs）、精神科医生和执业护士的角度，确定了AD停药的障碍和促进因素，并探讨了他们对自身在AD停药中具体作用的看法。我们进行了两次焦点小组讨论，参与者包括四名全科医生、六名药剂师和三名精神科医生，还对一名执业护士进行了访谈。讨论内容进行了录音，并逐字转录。我们使用理论领域框架进行了定向内容分析。确定了六个主题：患者识别、HCPs在AD停药方面的行为、恐惧和情绪、背景和资源、知识、证据和技能以及专业态度。所有HCPs都强调了提高对AD停药认识的重要性。障碍包括对复发或停药症状的恐惧、HCPs之间协作不佳以及资源匮乏。促进因素包括工具和指南的可用性。HCPs对彼此的角色和职责并不了解且不确定，不过他们表现出了提供指导的积极性。这需要专业协作协议和充足的资源。经验丰富的CPs可以通过识别AD使用者并提供信息/支持来发挥作用。
