Knowledge and Confidence in Psychotropic Prescribing, Utilisation of Guidelines and Resources in Managing Perinatal Mental Health in General Practice: An Australian Cross‐Sectional Survey

Objective Management of psychiatric disorders in the perinatal period is a common presentation in primary care. There is a need to understand how general practitioners (GPs) use guidelines and resources and incorporate the knowledge within clinical practice. This study aims to explore Australian GPs' knowledge and confidence in psychotropic prescribing in all stages of pregnancy in accordance with current guideline recommendations. Design Cross‐sectional anonymous online survey. Setting National GP survey was undertaken. Participants 132 GPs responded, 84% female, with 41% rural and 59% in metropolitan practice. Main Outcome Measure: exploring knowledge and confidence in psychotropic prescribing, vignettes of a range of clinical scenarios following recommended guidelines, and resource use and screening practices. Exploratory analysis using nonparametric tests occurred between sub‐groups within the data, including zones of practice and GP experience. Results Overall, 83% were confident in psychotropic prescribing, a percentage that decreases with more complex and specialised psychotropic medication usage. Rural GPs had higher levels of prescribing knowledge and confidence across scenarios; however, they ranked accessing support from perinatal and general psychiatry lower in treatment choices. Years of experience were not significant. All GPs were aware of clinical prescribing guidelines, with up to 95% having used them. This was less so, with only 37% aware of Australian national perinatal mental health guidelines. Discussion GPs have considerable knowledge and confidence and follow best practice recommendations in prescribing common psychotropic medications. The more complex the mental health requirements, the reduced level of confidence and need for greater specialist support. Differences in rural practice locations were observed and could be better served with streamlined support and referral pathways to specialist perinatal mental health advice. Clinical pharmacological practice guidelines were used; however, lack of awareness and usefulness of national guidelines on perinatal mental health could be improved by more specific guidance targeted to a GP population.