A Clinical Care Algorithmic Toolkit for Promoting Screening and Next-Level Assessment of Pediatric Depression and Anxiety in Primary Care

Honigfeld, Lisa; Macary, Susan J.; Grasso, Damion J.

doi:10.1016/j.pedhc.2017.01.008

Cited by 19 publications

(9 citation statements)

References 17 publications

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“…• Other tactics could include developing a clearly stated paper or computer-assisted algorithm of depression screening and incorporation of depression screening and management tools in the electronic system of patients' health records, including a clinical decision support sys-tem for depression care management: e.g. guidelines for treatment, follow-up scheduling and contact-information of local mental health services (Bajracharya et al, 2016;Honigfeld et al,2017). Development of a registry of screened patients could also be effective (Yang et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Vinogradova

Vrubļevska

Rancāns

2019

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.

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Section: Discussionmentioning

confidence: 99%

Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Vinogradova

Vrubļevska

Rancāns

2019

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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“…2 Since about 90% of youth in the United States regularly see a pediatric provider, the primary care office is the front line for MH. 3 Routine screening in pediatric primary care is one of the most widely recommended paths to earlier identification and prevention of MH problems. The American Academy of Pediatrics recommends that all youth ages 5 through 17 years be screened annually for MH problems using validated screening tools.…”

Section: Introductionmentioning

confidence: 99%

How an Electronic Medical Record System Facilitates and Demonstrates Effective Psychosocial Screening in Pediatric Primary Care

Arauz-Boudreau

Riobueno-Naylor

Haile

et al. 2019

Clin Pediatr (Phila)

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Using questionnaires, administrative claims, and chart review data, the current study explored the impact of using an electronic medical record system to administer, score, and store the Pediatric Symptom Checklist (PSC-17) during annual pediatric well-child visits. Within a sample of 1773 Medicaid-insured outpatients, the electronic system demonstrated that 90.5% of cases completed a PSC-17 screen electronically, billing codes indicating a screen was administered agreed with the existence of a questionnaire in the chart in 98.8% of cases, the classification of risk based on PSC-17 scores agreed with the classification of risk based on the Current Procedural Terminology code modifiers in 72.9% of cases, and 90.0% of clinicians’ progress notes mentioned PSC-17 score in treatment planning. Using an electronic approach to psychosocial screening in pediatrics facilitated the use of screening information gathered during the clinical visit and allowed for enhanced tracking of outcomes and quality monitoring.

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“…Referral patterns and quality represent import indicators of patient care that reflect professional practice behaviour and, compared with self-report of behavioural change, are relatively objective targets for measuring CME effect, 10 such as clinical outcomes. Outcomes, which are defined as the result of an action or activity, are salient to commentary on CME effectiveness as they may be quantified and are more objective.…”

Section: Introductionmentioning

confidence: 99%

Mental health literacy in primary care: Canadian Research and Education for the Advancement of Child Health (CanREACH)

et al. 2017

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The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/ untrained referring physicians (n=7753) making referrals over the same time period. Referrals were analysed for evidence of change based on frequencies and measures of clinical urgency. Participants of the training programme also completed standardised baseline and outcome selfevaluations. Congruent with participants self-reported evaluative reports of improved knowledge and practice, analysis of referral frequency and the clinical urgency of referrals to paediatric psychiatric services over the study period indicated that trained physicians made more appropriate referrals (clinically more severe) and reduced referrals to emergency services. Quantitative clinical differences as completed by intake clinicians blind to referrals from the study group designations were observed within the trained physician group pretraining and posttraining, and between the trained physician group and the unexposed physician group. The results illustrate a novel model for objectively measuring change among physicians based on training in paediatric mental health management. IntroductionContinuing medical education (CME) is grounded in the belief that with increased physician knowledge comes better physician practice which leads to improved patient outcomes. A measurable change in patients' health as a function of CME is rare. Most measures of CME effect focus on physician self-reported CME content uptake.1-6 Yet, it is well documented that self-report, as a consequence of CME participation, invariably suffers from the Hawthorne effect, 7 wherein self-reported effects are systematically biased simply through participation. There is little, if any, research employing independent, objective measures of CME programme change effect on physicians' practice. 8The gaps between perceived, actual and ideal performance in healthcare are real. For example, a recent meta-analysis found that most studies fail to show a significant correlation between CME and health outcomes.5 While research has focused on improving physician practice through an examination of various styles of CME, demonstrating that smaller interactive workshops show greater improvements than didactic sessions, 5 it has, to a lesser degree, examined CME effects on physician practice in relation to patient outcomes. When quantifiable, outcomes that are the result of an action or activity 1 are more objective, rendering them adequate and unbiased assessments of CME. 6 In fact...

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A Clinical Care Algorithmic Toolkit for Promoting Screening and Next-Level Assessment of Pediatric Depression and Anxiety in Primary Care

Cited by 19 publications

References 17 publications

Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

How an Electronic Medical Record System Facilitates and Demonstrates Effective Psychosocial Screening in Pediatric Primary Care

Mental health literacy in primary care: Canadian Research and Education for the Advancement of Child Health (CanREACH)

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