Supporting antidepressant discontinuation: the development and optimisation of a digital intervention for patients in UK primary care using a theory, evidence and person-based approach.

BMJ Open
Hannah M BowersAdam W A Geraghty

Abstract

We aimed to develop a digital intervention to support antidepressant discontinuation in UK primary care that is scalable, accessible, safe and feasible. In this paper, we describe the development using a theory, evidence and person-based approach. Intervention development using a theory, evidence and person-based approach. Primary Care in the South of England. Fifteen participants with a range of antidepressant experience took part in 'think aloud' interviews for intervention optimisation. Our digital intervention prototype (called 'ADvisor') was developed on the basis of a planning phase consisting of qualitative and quantitative reviews, an in-depth qualitative study, the development of guiding principles and a theory-based behavioural analysis. Our optimisation phase consisted of 'think aloud' interviews where the intervention was iteratively refined. The qualitative systematic review and in-depth qualitative study highlighted the centrality of fear of depression relapse as a key barrier to discontinuation. The quantitative systematic review showed that psychologically informed approaches such as cognitive-behavioural therapy were associated with greater rates of discontinuation than simple advice to reduce. Following a beha...Continue Reading

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Methods Mentioned

BETA
Cognitive Behavioural Therapy

Software Mentioned

REDUCE
COM
ADvisor

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