Bowers, HM, Kendrick, T, Glowacka, M, Williams, S, Leydon, G, May, C, Dowrick, C 
ORCID: 0000-0002-4245-2203, Moncrieff, J, Laine, R, Nestoriuc, Y et al (show 2 more authors)
(2020)
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, 10 (3).
e032312-.
ISSN 2044-6055, 2044-6055
Abstract
Objectives 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. Design Intervention development using a theory, evidence and person-based approach. Setting Primary Care in the South of England. Participants Fifteen participants with a range of antidepressant experience took part in think aloud' interviews for intervention optimisation. Intervention 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. Results 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 behavioural diagnosis based on the behaviour change wheel, social cognitive theory provided a theoretical basis for the intervention. The intervention was optimised on the basis of think aloud interviews, where participants suggested they like the flexibility of the system and found it reassuring. Changes were made to the tone of the material and the structure was adjusted based on this qualitative feedback. Conclusions ADvisor' is a theory, evidence and person-based digital intervention designed to support antidepressant discontinuation. The intervention was perceived as helpful and reassuring in optimisation interviews. Trials are now needed to determine the feasibility, clinical and cost-effectiveness of this approach.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Antidepressive Agents, Depression, Qualitative Research, Adult, Aged, Middle Aged, Primary Health Care, Female, Male, Practice Guidelines as Topic, United Kingdom, Cognitive Behavioral Therapy, Drug Tapering |
| Divisions: | Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 23 Jul 2021 10:07 |
| Last Modified: | 24 Jan 2026 02:28 |
| DOI: | 10.1136/bmjopen-2019-032312 |
| Open Access URL: | http://doi.org/10.1136/bmjopen-2019-032312 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3131058 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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