Published Papers - Abstract 160

Outram S & Cockburn J. They are a cover up and don't solve the problem : Women's perceptions of the use of prescribed psychotropic medicines for psychological distress. Women and Health, ; :

This paper uses qualitative and quantitative methods to describe the use of prescribed and non-prescribed medicines, the sociodemographic and health related factors associated with use of medicines, and the experiences and perceptions of their use by midlife women identified as having a recent period of psychological distress. Data were gathered using semi-structured telephone interviews in NSW Australia between August and December 1997. The respondents were 322 women aged 46-50 who took part in the baseline survey of the Australian Longitudinal Study in Women’s Health.Thirty-six percent of women reported using medicines (including those prescribed by a general practitioner, those prescribed by another doctor and those not prescribed) to help them cope. Taking medicines was significantly associated with a lower mental health score on the MHI-5 (OR= 0.98 CI 0.96-1.00) and an increasing number of negative life events (OR= 1.14 CI 1.05-1.24). Taking medicines prescribed by a general practitioner (GP) was associated with being dissatisfied with one’s family relationships (OR= 0.52 CI 0.30-0.91), and having gone through menopause in the past year (OR=1.68 CI 1.00-2.81). Qualitative data (n=117) showed small numbers of women who were either happy with or ambivalent about the prescription of psychotropic medicines by their GP, and a large number who expressed negative comments. The main themes in these negative comments were: a belief in natural remedies, unacceptable side-effects and fear of dependency, a belief that medicines cover up the problems that need to be solved, and the perception that the prescription of psychotropic medicines represents poor care by the GP. Although GPs often assume that patients expect a prescription, many women want the GP to listen to their problems and regard a prescription for medicines as poor care for psychological distress. Taking a partnership approach with women involving discussion of previous experiences with psychotropic medicines and perceptions of the medicines and their alternatives, is essential if GPs are to achieve the objectives of quality use of medicines and patient satisfaction.