dc.contributor.author | Guirguis, Ayman | |
dc.contributor.author | Almond, Michael | |
dc.contributor.author | Chilcot, Joseph | |
dc.contributor.author | Davenport, A. | |
dc.contributor.author | Wellsted, David | |
dc.contributor.author | Farrington, Kenneth | |
dc.date.accessioned | 2020-03-04T01:11:44Z | |
dc.date.available | 2020-03-04T01:11:44Z | |
dc.date.issued | 2020-06-01 | |
dc.identifier.citation | Guirguis , 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.issn | 1755-6678 | |
dc.identifier.other | ORCID: /0000-0002-2895-7838/work/106342694 | |
dc.identifier.uri | http://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.abstract | Background: 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.extent | 9 | |
dc.format.extent | 337750 | |
dc.language.iso | eng | |
dc.relation.ispartof | Journal of Renal Care | |
dc.subject | Antidepressants | |
dc.subject | Chronic kidney disease | |
dc.subject | Clinical practice guidelines | |
dc.subject | Depression | |
dc.subject | Haemodialysis | |
dc.subject | Major depressive disorder | |
dc.subject | Selective serotonin reuptake inhibitors | |
dc.subject | Nephrology | |
dc.subject | Advanced and Specialised Nursing | |
dc.title | Antidepressant Usage in Haemodialysis Patients: Evidence of Sub-optimal Practice Patterns | en |
dc.contributor.institution | Centre for Health Services and Clinical Research | |
dc.contributor.institution | Basic and Clinical Science Unit | |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.contributor.institution | Health Research Methods Unit | |
dc.contributor.institution | Centre for Research in Psychology and Sports | |
dc.contributor.institution | Department of Psychology and Sports Sciences | |
dc.contributor.institution | Behaviour Change in Health and Business | |
dc.contributor.institution | Psychology | |
dc.contributor.institution | Department of Clinical, Pharmaceutical and Biological Science | |
dc.contributor.institution | Department of Psychology, Sport and Geography | |
dc.description.status | Peer reviewed | |
dc.date.embargoedUntil | 2021-02-20 | |
dc.identifier.url | http://www.scopus.com/inward/record.url?scp=85079383079&partnerID=8YFLogxK | |
rioxxterms.versionofrecord | 10.1111/jorc.12320 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |