Prevalence and variation in antidepressant prescribing across Northern Ireland: a longitudinal administrative data linkage study for targeted support.
A multi-disciplinary team of experienced academic researchers and the award winning NI charity, Aware Defeat Depression (Aware), aim to maximise the use of Census and Enhanced Prescribing Database data in NI to target, tailor and implement support for individuals in receipt of antidepressant prescriptions and to stimulate 'social prescribing' across the region (a mechanism for linking patients with non-medical sources of support within the community).
Specifically the study aims to (i) provide a detailed geographical breakdown of antidepressant prescribing in NI to identify prescription 'hot spots' at a small geographical level, (ii) use linked census data to identify demographic variables (personal, social, and economic factors) that differentiate 'hot spots', (iii) determine if the association between demographic variables and 'hot spots' differs by geographical location, (iv) determine if long-term changes in people's lives (e.g. change in deprivation, family structure, physical health) are associated with antidepressant use and (v) stimulate 'social prescribing' across the region through targeted intervention.
On the basis of the proposed analytic strategy the project team aims to develop a nationwide map detailing the socio-economic landscape of antidepressant prescribing in NI. This map will support the non-academic partners (Aware) in their efforts to develop and implement effective and coordinated intervention programs by (i) highlighting prescription hotspots at a small geographical level (ii) generating 'risk' profiles specific to identified hotspots using personal, social and economic data and (iii) identifying 'vulnerability' at a personal, social and economic level through longitudinal change modelling.
The project team are committed to engaging with key stakeholders in the area of community action, and at a public health, primary care, and national policy level. While the NI client base of the projects non-academic partner, Aware Defeat Depression, will be the primary beneficiaries of the research, Aware themselves and other primary care service providers will also directly benefit from the work. The proposed project will also be of interest to a wide range of academic disciplines (public health researchers, epidemiologists etc.).
How will they benefit?
Aware Defeat Depression (Members & Client Base): Partnership with Aware will ensure that the analytic process and findings will directly inform targeted intervention. Aware, the only charity working exclusively for those with depression in NI, is an established support network ideally positioned to deliver impact. Aware has been delivering intensive education and training programmes to thousands of adolescents and adults across NI since 1996 and has been awarded the GSK IMPACT Award in 2014. A primary focus of these programmes is to educate individuals about positive strategies that can be used in the recovery from depression. Aware, on the basis of the project findings, will be in a position to better tailor, target and promote 'social prescribing' in those areas and among those individuals in NI that need it most.
NI Primary Care Service Providers, GPs and their patients: While Aware can communicate directly with those in receipt of antidepressant medications across NI, primary care service providers and general practitioners constitute another important stakeholder. Through the project, Aware can offer a valuable opportunity to alleviate pressures in primary care (and associated prescription practices) in NI and to link GP patients with a wide range of non-medical sources of support within the community that may address their needs in more effective and diverse ways. In relation to the project report findings specifically, primary care health workers and GPs will be directly informed of (i) variations in prescription rates across NI and (ii) the socio-economic context of prescribing rates in their jurisdiction.
What will be done to ensure that they have the opportunity to benefit?
- A project website and social media account will be created. Specific consideration will be given to non-academic bodies in the design of the website. For maximum impact and utility an interactive map based on GIS principles will be designed. This application will provide users with an efficient means of navigating the project findings geographically.
- A targeted intervention strategy for delivering focused, context sensitive social prescribing across NI will be formulated by the project team. Using the project findings Aware will target services to 'high-risk' areas across NI.
- A summary report and pathways to policy document will be compiled and sent to the ADRN, the Office of First Minister and Deputy First Minister in NI and the Royal College of General Practitioners Northern Ireland.
- On completion of the analyses the team will organise a briefing conference to ensure that project findings are effectively communicated to all stakeholders.
More about the research
For further information on this project, please follow us on Twitter (@ADSoPP_NI) or visit our blog: https://adsopp.wordpress.com
Professor Mark Shevlin