Depression, Comorbidities, and Prescriptions of Antidepressants in a German Network of GPs and Specialists with Subspecialisation in Anthroposophic Medicine: A Longitudinal Observational Study

Abstract

Background. Depression is a major reason for counselling in primary care. Our study aims at evaluating pharmacological treatment strategies among physicians specialised in anthroposophic medicine (AM). Methods. From 2004 to 2008, twenty-two German primary care AM-physicians participated in this prospective, multicentre observational study. Multiple logistic regression was used to determine factors associated with a prescription of any antidepressant medication. Results. A total of 2444 patients with depression were included (mean age: 49.1 years (SD: 15.4); 77.3% female). 2645 prescriptions of antidepressants for 833 patients were reported. Phytotherapeutic preparations from Hypericum perforatum were the most frequently prescribed antidepressants over all (44.6% of all antidepressants), followed by amitriptyline (16.1%). The likelihood of receiving an antidepressant medication did not depend on comorbidity after controlling for age, gender, physician specialisation, and type of depression (adjusted OR (AOR) = 1.01; CI: 0.81–1.26). Patients who had cancer were significantly less likely to be prescribed an antidepressant medication than those who had no cancer (AOR = 0.75; CI: 0.57–0.97). Conclusion. This study provides a comprehensive analysis of everyday practice for the treatment of depression in AM -physicians. Further analysis regarding the occurrence of critical combinations is of high interest to health services research.

St John's wort for depression: scoping review about perceptions and use by general practitioners in clinical practice

“…However, Jeschke et al . undertook a longitudinal observation study from 2004 to 2008 of treatment strategies among a subpopulation of GPs in Germany that specialise in anthroposophic medicine (CAM).…”

“…Jeschke [67] 2012 Germany Evaluation of pharmacological treatment strategies among physicians in anthroposophic medicine Prospective multicentre longitudinal observational study 22 physicians, 2444 patients Livingston [22] 2010 Australia Determine attitudes of GPs about CAM and identify factors that predict their recommendations…”

“…However, Jeschke et al [67] undertook a longitudinal observation study from 2004 to 2008 of treatment strategies among a subpopulation of GPs in Germany that specialise in anthroposophic medicine (CAM). Obviously the philosophic predilections of these GPs may bias them towards the use of CAM.…”

Predictors of sick leave days in patients affected by major depressive disorder receiving antidepressant treatment in general practice setting in Germany

“…The German Association for Psychiatry and Psychotherapy (DGPPN) research project on mental healthcare utilisation in Germany found that non-psychiatric disciplines, like general practice, were the most frequently used providers of outpatient mental health care (Gaebel et al 2012). In addition, due to the increasing number of depressed patients and the development of new antidepressant drugs, primary care physicians today play an important role in the treatment of these conditions (Jeschke et al 2012;Freytag et al 2017). Based on these reasons, the present study was focussed on primary care, analysing data from approximately 5 million patient records collected from across more than 1,500 GPs.…”