GP guidelines recomend suicide check within 9 months of antidep script

The study of 33,483 patients from 88 practices, who had evidence of depression in their notes, found 96 per cent were on antidepressants despite having no recorded episode of depression in the previous two years. There was also evidence GPs were ignoring local guidelines recommending referral and a suicide risk check within nine months of a first depressive episode or antidepressant script.




GPs risk legal action over poor depression notes










03 Aug 03



GPs are failing to keep adequate notes to show they manage patients on antidepressants appropriately.



The findings of a major study prompted a warning from medicolegal experts that GPs could be hauled before the GMC and face legal claims for failing to document their monitoring of patients.



The study of 33,483 patients from 88 practices, who had evidence of depression in their notes, found 96 per cent were on antidepressants despite having no recorded episode of depression in the previous two years. There was also evidence GPs were ignoring local guidelines recommending referral and a suicide risk check within nine months of a first depressive episode or antidepressant script.



Only 10 per cent of 1,391 patients with a recorded episode were referred and 2 per cent had suicide risk recorded, according to results presented to the Society for Academic Primary Care annual conference last month.



Research leader Keith Prescott, educational facilitator in general practice at Queen Mary University of London, said depression's episodic nature made it 'crucial' GPs recorded each episode and reviewed patients.



Lawyers preparing a class action over Seroxat warned in June that any GP appearing to prescribe inappropriately could be vulnerable to legal action.



Dr Stephanie Bown, head of medical services at the Medical Protection Society, said failure to document patient monitoring or what led to an antidepressant script would make it harder for GPs to defend their actions.



'If it's shown you have been irresponsible by continuing to prescribe without showing that patient had been reviewed, you could face a clinical negligence claim and you could find yourself up before the GMC.'



Dr Arnold Zermansky, author of Government guidelines on medication review, said GPs' fears over withdrawing drugs from 'quiet, satisfied patients' and the extra work involved in review could explain why so many with no recent depressive episode were on antidepressants.



The new contract awards 23 quality points for 15-monthly reviews of patients with severe long-term mental health problems