A major indemnity organisation is warning GPs to take care when treating depressed patients.
The Medical Defence Union says it has paid out nearly £3 million in compensation on behalf of GP members to settle 30 claims arising from the treatment of patients with depression during a recent ten-year-period.
In the latest edition of the MDU Journal, Professor Femi Oyebode, consultant psychiatrist and MDU Council member, analysed the main reasons for claims relating to the diagnosis and management of patients with depression (excluding post-natal depression).
“Depression is a relatively common presentation in general practice and in most cases, the care of patients with depression is generally straightforward and without incident. However when something does go wrong, the nature of the condition and the type of medication involved means there is significant potential for an adverse outcome, including the risk that the patient will harm themselves in some way, including a small number of tragic cases where a patient has committed suicide,” said Professor Oyebode.
Examples of cases settled by the MDU include more than £1m paid out to a patient with a history of depression who was left severely brain damaged following an overdose after being prescribed the antimalarial drug mefloquine; over £21,000 paid out to a patient who became addicted to an antidepressant; and a GP who missed a fractured hip in an elderly patient with depression after he visited the doctor following a fall. The patient received over £6,500 in compensation.
Professor Oyebode says there are three main areas of risk when treating depressed patients, these being: problems with medication, failure to diagnose or treat an unrelated condition in a depressed patient and failure to recognise the risk of suicide in a depressed patient.
GPs are advised to take care with prescription drugs with similar names and dosages, particularly those that come in different formulae and strengths. They are urged to be aware of the risk of drug interactions, for example between lithium and diuretics. They are encouraged to keep up-to-date with current guidance, to have a system in place to review patients on long-term medication, and to ensure that patients have been warned about side effects.
In addition, Professor Oyebode says patients who present with depression should be assessed regularly for the risk of suicide.