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dc.contributor.authorGuirguis, Ayman
dc.contributor.authorAlmond, Michael
dc.contributor.authorChilcot, Joseph
dc.contributor.authorDavenport, A.
dc.contributor.authorWellsted, David
dc.contributor.authorFarrington, Kenneth
dc.date.accessioned2020-03-04T01:11:44Z
dc.date.available2020-03-04T01:11:44Z
dc.date.issued2020-06-01
dc.identifier.citationGuirguis , A , Almond , M , Chilcot , J , Davenport , A , Wellsted , D & Farrington , K 2020 , ' Antidepressant Usage in Haemodialysis Patients: Evidence of Sub-optimal Practice Patterns ' , Journal of Renal Care , vol. 46 , no. 2 , pp. 124-132 . https://doi.org/10.1111/jorc.12320
dc.identifier.issn1755-6678
dc.identifier.otherPURE: 19408318
dc.identifier.otherPURE UUID: fbe75230-3dc7-40b4-a841-3a889feafe52
dc.identifier.otherScopus: 85079383079
dc.identifier.urihttp://hdl.handle.net/2299/22381
dc.description© 2020 European Dialysis and Transplant Nurses Association/European Renal Care Association. This is the peer reviewed version which has been published in final form at https://doi.org/10.1111/jorc.12320. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
dc.description.abstractBackground: Depression is common in patients on haemodialysis and associated with adverse outcomes. Antidepressant use is widespread though evidence of efficacy is limited. Objectives: To study antidepressant management practices in patients on haemodialysis with reference to NICE guidelines on management of depression in adults with chronic physical health problems. Design: Prospective, multicentre, longitudinal cohort study with 6–15 month follow-up. Participants: Patients on haemodialysis established on antidepressant medication. Measurements: Baseline assessment of mood was undertaken using Beck Depression Inventory (BDI-II). Demographic, clinical and medication data were also collected. Changes in clinical and life circumstances and medication during follow-up were recorded. At follow-up, BDI-II was reassessed and diagnostic psychiatric assessment undertaken. Results: Forty-one patients were studied. General practitioners were the main prescribers (68%). Ten agents were in use, the commonest being Citalopram (39%). Doses were often suboptimal. At baseline, 30 patients had high BDI-II scores (≥16) and 22 remained high at follow-up. Eleven had BDI-II < 16 at baseline. In five, this increased on follow-up to ≥16. Sixteen patients (39%) had no medication review during follow-up, 14 (34%) had a dose review, and 11 (27%) a medication change. On psychiatric assessment at follow-up, eight patients had current major depressive disorder (MDD), seven recurrent and 20 evidence of past MDD. Six displayed no evidence of ever having MDD. Conclusions: Antidepressant management in patients on haemodialysis reflected poor drug selection, overprescription, under-dosing and inadequate follow-up suggesting sub-optimal adherence to NICE guidelines. Most patients had high depression scores at follow-up. Antidepressant use in haemodialysis requires reappraisal.en
dc.format.extent9
dc.language.isoeng
dc.relation.ispartofJournal of Renal Care
dc.rightsEmbargoed
dc.subjectAntidepressants
dc.subjectChronic kidney disease
dc.subjectClinical practice guidelines
dc.subjectDepression
dc.subjectHaemodialysis
dc.subjectMajor depressive disorder
dc.subjectSelective serotonin reuptake inhibitors
dc.subjectNephrology
dc.subjectAdvanced and Specialised Nursing
dc.titleAntidepressant Usage in Haemodialysis Patients: Evidence of Sub-optimal Practice Patternsen
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionHealth Research Methods Unit
dc.contributor.institutionCentre for Research in Psychology and Sport Sciences
dc.contributor.institutionDepartment of Psychology and Sports Sciences
dc.contributor.institutionBehaviour Change in Health and Business
dc.contributor.institutionPsychology
dc.contributor.institutionDepartment of Clinical, Pharmaceutical and Biological Science
dc.contributor.institutionDepartment of Psychology, Sport and Geography
dc.description.statusPeer reviewed
dc.date.embargoedUntil2021-02-20
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85079383079&partnerID=8YFLogxK
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Accepted Version
dcterms.dateAccepted2020-06-01
rioxxterms.versionAM
rioxxterms.versionofrecordhttps://doi.org/10.1111/jorc.12320
rioxxterms.licenseref.uriOther
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeEmbargoed


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