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SHARECase Study: HRT and Antidepressant Prescribing Review
Work Completed
- 150 female patients co-prescribed HRT and a first-line antidepressant were identified and reviewed.
- Individual clinical assessments were conducted to determine appropriateness of dual therapy.
- 52 patients were excluded as not clinically appropriate for intervention.
- 97 patients were invited for a structured medication review with the Medicines Management Team.
- Patients were contacted via SMS and offered consultations to consider deprescribing.
- Additional support offered included referral to our Health Connections team, lifestyle advice, and our 6 week Habits for Health programme.
Key Results
- 53 out of 97 patients (56%) reduced or stopped their antidepressant following review.
- 44 out of 97 patients (44%) declined intervention.
- 18 patients accepted referral for lifestyle and wellbeing support.
- A proportion of patients were identified where symptoms may have been menopause-related or due to underlying physical health conditions rather than primary mental health diagnoses.
Annual Impact
- Cost saving: £578.76 per year
- Carbon saving: 90 kg CO₂e per year
- Carbon equivalent: ~475 km of car travel
Learning Points
- Menopausal symptoms can mimic anxiety and depression, therefore consider hormonal causes before initiating antidepressants.
- Review ongoing need for antidepressants when HRT is started.
- Holistic assessment (including blood tests where appropriate) is essential to rule out underlying conditions (e.g. thyroid dysfunction, B12 deficiency).
- Medication reviews are key opportunities to identify deprescribing potential.
- SMS invitations and structured reviews are effective tools for engaging patients.
- Deprescribing contributes to both financial and environmental sustainability within the NHS.
- This approach could be applied to other areas where antidepressants may be prescribed for alternative underlying causes.