Community Pharmacists' Role in Antidepressant Discontinuation: A Survey of Barriers and Facilitators

Abstract

Background

Long-term antidepressant use is widespread in high-income countries. While general practitioners (GPs) are central in reviewing and discontinuing antidepressants, community pharmacists (CP) may support this process. However, barriers and facilitators to CP involvement remain underexplored.

Aim

This study aims to explore CPs' perceptions of long-term antidepressant discontinuation and their roles in the antidepressants discontinuation process and to identify key barriers and facilitators for engaging in this process.

Methods

A cross-sectional online survey was conducted among Belgian CPs. Items assessing perceived roles and barriers/facilitators were rated on Likert scales and categorized by mean scores.

Results

A total of 190 CPs completed the survey. Pharmacists identified their main responsibilities as informing patients, compounding tapering formulations and contacting physicians during tapering when problems arise. The only barrier classified as major was resistance from GPs to antidepressant discontinuation. Eleven major facilitators were identified, including patient-initiated requests, good GP collaboration, strong trust relationships with patients and access to guidelines, information and education on discontinuation of antidepressants.

Conclusion

CPs currently tend to adopt a largely reactive approach towards discontinuing long-term antidepressants. Interventions aiming to promote more proactive engagement may focus on clarifying roles and responsibilities, strengthening collaboration with GPs and supporting pharmacists through education, practical resources and communication training.