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Factors influencing the duration of treatment with psychotropic drugs in general practice: a survival analysis approach

Published online by Cambridge University Press:  09 July 2009

Paul Williams
Paul Williams*
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr Paul Williams, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
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Synopsis

There have been few previous attempts to study factors which affect the duration of treatment with psychiatric drugs in general practice. In the present study ‘duration of treatment’ was regarded as analogous to ‘survival time’, and techniques of survival analysis were applied to data from a previously published study of psychotropic drug use in general practice (Williams et al. 1982). Methods of logistic modelling were used in an attempt to construct a comprehensive and parsimonious model to describe and predict the duration of psychotropic use. Such a model was found to include the effects of previous psychotropic treatment, social problems, duration of treatment and general practitioner behaviour. The implications of the findings, vis à vis the prevention of unnecessary long-term psychotropic drug use, are discussed.

Type
Research Article
Information
Psychological Medicine , Volume 13 , Issue 3 , August 1983 , pp. 623 - 633
Copyright
Copyright © Cambridge University Press 1983

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References

Bain, D. J. & Haynes, A. J. (1975). A year's study of drug prescribing in general practice using computer-assisted records. Journal of the Royal College of General Practitioners 24, 203–207.Google Scholar
Benjamin, B. (1968). Health and Vital Statistics. Allen & Unwin: London.Google Scholar
Committee on the Review of Medicines (1980). Systematic review of the benzodiazepines. British Medical Journal i, 910–912.Google Scholar
Cox, D. R. (1970). Analysis of Binary Data. Chapman & Hall:London.Google Scholar
Department of Health and Social Security (1976). Drug Master Index. Unpublished.Google Scholar
Drury, V. W. M. (1982). Repeat prescribing – a review. Journal of the Royal College of General Practitioners 32, 42–45.Google ScholarPubMed
Dunn, G. (1981). The role of linear models in psychiatric epidemiology. Psychological Medicine 11, 179–184CrossRefGoogle ScholarPubMed
Dunn, G. & Master, D. (1982). Latency models: the statistical analysis of response times. Psychological Medicine 12, 659–666.CrossRefGoogle Scholar
Dunn, G. & Skuse, D. (1981). The natural history of depression in general practice: stochastic models. Psychological Medicine 11,755–764.CrossRefGoogle ScholarPubMed
Eaton, W. W. & Whitmore, G. A. (1977). Length of stay as a stochastic process: a general approach and application to hospitalisation for schizophrenia. Journal of Mathematical Sociology 5, 273–292.CrossRefGoogle Scholar
Fienberg, S. E. & Mason, W. (1978). Identification and estimation of age, period and cohort models in the analysis of discrete archival data. In Sociological Methodology (ed. Schüssler, K.), pp. 1–67. Jossey-Bass: San Francisco.Google Scholar
Goldberg, D. & Huxley, p. (1980). Mental Illness in the Community. Tavistock: London.Google Scholar
Kalbfleisch, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data. Wiley: New York.Google Scholar
Lader, M. H. (1978). Benzodiazepines: the opium of the masses? Neuroscience 3, 159–165.CrossRefGoogle ScholarPubMed
Lee, E. T. (1980). Statistical Methods for Survival Data Analysis. Lifetime Publications: Belmont, California.Google Scholar
Lee, E. T. & Desu, M. M. (1972). A computer program for comparing K samples with right-censored data. Computer Programs in Biomedicine 2, 315–321.CrossRefGoogle ScholarPubMed
Manasse, A. P. (1974). Repeat prescriptions in general practice. Journal of the Royal College of General Practitioners 24, 203–207.Google ScholarPubMed
Marks, J. (1978). The Benzodiazepines. MTP Press: Lancaster.CrossRefGoogle Scholar
Marks, J. (1983). Benzodiazepines – for good or for evil? International Pharmacopsychiatry (in the press).Google Scholar
Mellinger, G. D. & Balter, M. B. (1982). Prevalence and patterns of use of psychotherapeutic drugs. In The Epidemiological Impact of Psychotropic Drugs (ed. Tognoni, G., Bellantuono, C. and Lader, M.), pp. 117–136. Elsevier: Amsterdam.Google Scholar
Mindham, R. H. S., Howland, C. & Shepherd, M. (1973). An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine 3, 5–17.CrossRefGoogle ScholarPubMed
Murray, J., Dunn, G. & Tarnopolsky, A. (1982). Self-assessment of health: an exploration of the effect of physical and psychological symptoms. Psychological Medicine 12, 371–378.CrossRefGoogle ScholarPubMed
Parish, P. A. (1971). The prescribing of psychotropic drugs in general practice. Journal of the Royal College of General Practitioners 21, Suppl. 4, 1–77.Google ScholarPubMed
Peto, R., Pike, M. C., Armitage, P., Breslow, N. E., Cox, D. R., Howard, S. V., Mantel, N., McPherson, K., Peto, J. & Smith, P. G. (1977). Design and analysis of randomised clinical trials requiring prolonged observation of each patient: II. Analysis and examples. British Journal of Cancer 35, 1–39.CrossRefGoogle ScholarPubMed
Peturrson, H. & Lader, M. H. (1981). Benzodiazepine dependence. British Journal of Addiction 76, 133–145.CrossRefGoogle Scholar
Royal College of General Practitioners (Birmingham Research Group) (1978). Practice activity analysis: 4. Psychotropic drugs. Journal of the Royal College of General Practitioners 28, 122–124.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.Google Scholar
Skegg, D. C. G., Doll, R. & Perry, J. (1977). Use of medicines in general practice. British Medical Journal i, 1561–1563.CrossRefGoogle Scholar
Williams, P. (1979). The extent of psychotropic drug prescription. In Psychosocial Disorders in General Practice (ed. Williams, P. and Clare, A. W.), pp. 151–160. Academic Press: London.Google Scholar
Williams, P. (1983). Patterns of psychotropic use. Social Science and Medicine (in the press).CrossRefGoogle Scholar
Williams, P., Murray, J. & Clare, A. W. (1982). A longitudinal study of psychotropic drug prescription. Psychological Medicine 12,201–206.CrossRefGoogle ScholarPubMed