A population-base study of antidepressants utilisation, adherence, and persistence in Scotland (2015-2023)
Project reference: RAS-24-94
Approval date: 15 July 2025
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Lead organisation |
Principal Investigator |
|---|---|
| University of Strathclyde | Tanja Mueller |
Lay summary
The Scottish Health Survey 2022 reported that one in six adults in Scotland experienced moderate to severe depressive symptoms. Antidepressants are widely prescribed for managing these symptoms due to their proven effectiveness and tolerability.
The same survey found that antidepressant use in Scotland increased by 50% over the past decade. While adherence to antidepressants is crucial for achieving remission, many patients stop treatment too soon, increasing their risk of relapse, leading to higher healthcare costs, and worsening mental health outcomes.
On the other hand, some individuals continue taking antidepressants for extended periods without a clear clinical need, which can lead to unnecessary long-term use. In Scotland, about 60% of adults using antidepressants have been on them for more than two years.
This study will examine how many adults with depression in Scotland prescribed antidepressants, how many start using them, and how often they do not take them as prescribed.
Public benefit statement
The project underwent multiple reviews by the supervisory team at the University of Strathclyde, which includes experienced pharmacists, Dr Natalie Weir, Dr Tanja Mueller and Prof. Margaret Watson. Additionally, it was independently reviewed several times by Prof. Amanj Kurdi (a pharmacist and researcher also affiliated with the University of Strathclyde) in his capacity as the internal assessor for this PhD project.
This project is focused on improving care for people with depression in Scotland by understanding how often patients stop taking their prescribed antidepressants and which groups are more likely to struggle with staying on their treatment. We will use national prescribing data in Scotland to track how patients use their antidepressants over time and explore factors such as age, sex, and area of residence that may influence adherence.
1. Help the system better understand the health and care needs for a population: Depression affects many people across Scotland, yet we know that many patients stop taking their antidepressants too early, often without support. This study will highlight how common this issue is and help us understand which groups in the Scottish population are most affected. This will support a better understanding of the mental health needs across different communities.
2. Lead to identification and improvement of treatment or intervention or health care system design: By identifying which patients are most likely to discontinue treatment, this research can support the development of tailored interventions - such as pharmacist-led reviews or targeted follow-ups - to help people continue their treatment safely. These improvements can be embedded within existing pharmacist-led medication reviews.
3. Advance understanding of the needs for, or effectiveness of, preventative health care measures: Staying on antidepressant treatment as prescribed can prevent relapse and worsening of symptoms. This project helps us understand who may need extra support early on, allowing for more proactive and preventative mental health care in primary care and community pharmacy settings.
4. Better inform those planning health services and programmes: Our findings will provide evidence to inform local and national service planners - such as NHS boards and Public Health Scotland - about where to focus resources, ensuring support is directed to the people and areas with the greatest need.
5. Evidence base for public service delivery: By highlighting gaps in treatment adherence and showing where additional support could help, this study provides a foundation for improving how mental health services are delivered across Scotland—especially through community-based care like pharmacies and primary care teams.
Datasets used