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Quantifying the Impact of Patient-Practice Relationship Quality on the Levels of the Average Annual Antidepressant Practice Prescribing Rate in Primary Care in England.

Objective
The National Health Service (NHS) in England makes data on demographics, prescribing, location, and specific conditions in general practice (GP) practices publicly available. The GP Patient Survey captures patients' views of their GP practice. The objective of this study was to determine how patient experience of a GP may relate to the volume of antidepressant prescribing at that practice.


Methods
We examined how antidepressant prescribing rates relate to specific NHS GP Patient Survey metrics. Postal questionnaires were sent out to 2.2 million adults registered with GP practices in England from January to March 2018. The national survey response rate was 34.1%.


Results
The average annual antidepressant practice prescribing rate (AAAPPR) was 0.11, with 90% of practices falling between 40% and 160% of this value. Practices with a higher overall experience rating prescribed more antidepressants. Practices more effective in empowering their patients, as assessed by "How confident are you that you can manage any issues arising from your condition (or conditions)," prescribed less antidepressants. The difference between the lowest and highest decile of prescribing for this response was over 10% and potentially modified by changing practice approach.


Conclusions
There are opportunities to optimize antidepressant prescribing in GP practices. Antidepressants are a key facet of depression treatment. Our findings show that patient empowerment is a key modulator of antidepressant prescribing.