Project #105:
Antidepressant trends in those with Learning Disability and Autism and changes during Covid

The STOMP initiative launched in 2016 sought to reduce inappropriate prescribing of psychotropics among those with learning disability and autism (LD&A). Many non-pharmacological options to managing anxiety, distress and behavioural problems in LD&A require access to specialist staff, communal spaces, specialist learning environments and much of this was restricted during the COVID-19 lockdown.

In the Quality and Outcomes Framework, 2020-2021 report, NHS Digital found depression to have the greatest increase in QOF recorded prevalence, an increase of 0.7 percentage points from 2019-2020. The QOF framework also includes an indicator for depression diagnosis review.

This study will describe how the diagnosis and review of depression and the use of psychotropic medicines in the vulnerable LD&A population may have changed before and during the COVID-19 pandemic.

OpenSAFELY-TPP and OpenSAFELY-EMIS will be used to identify patients of any age with a diagnosis of learning disability or autism. For the study period of January 2018 to January 2022 monthly rates of current and new depression diagnosis and current and new antidepressant prescription will be described, looking separately at Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants (Tricyclics, Monoamine oxidase inhibitors (MAOIs) and others). Based on the QOF metric DEP003, the monthly rates of individuals 18 and older who received a review for a new diagnosis of depression within 10 to 65 days will also be described.