Ensure individuals are assessed and read coded for the condition being treated

Only a minority of individuals have a clear electronically recorded (read code) indication for receiving an antidepressant.⁷ Although the indication for the antidepressant can be identified from free-text entries in electronic and paper clinical notes, these are not easily identified unless an individual’s clinical record is accessed and specifically searched for.⁷ Therefore, appropriately coding of individuals’ records would support easier identification for proactive medication reviews in general practice and specialist services, as prescribers have indicated that:

‘...patients can get lost in the system, and that systems which adequately prompt medication reviews would be useful in broaching discontinuation with patients.’¹⁴

Healthcare practitioners and clinical teams should ensure individuals are appropriately coded in their electronic clinical systems:

Depression (code E2B), anxiety with depression (E2003), bipolar affective disorder (Eu32), etc.
Anxiety disorder such as generalised anxiety disorder (GAD, E2002), post-traumatic stress disorder (PTSD, Eu431), etc.
Chronic pain (1M52), neuropathic pain (N2423), diabetic neuropathic pain (1M8) and chronic pain review recorded as 66n when a review is undertaken.
For a polypharmacy review, if reviewing existing treatment prior to initiation of antidepressant medicines, use read code 8B31B Polypharmacy medication review.
Where the condition has resolved and the antidepressant has been stopped, please use the appropriate read code e.g. depression resolved (212S), anxiety resolved (2126J). (Other read codes for resolution of symptoms are not currently available on general practice systems.)