Improving Depression Screening in Primary Care

Lindsay, Marlene; Decker, Veronica

doi:10.1891/jdnp.2021-0005

Cited by 2 publications

(1 citation statement)

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“…Quality improvement projects introducing standard of care procedures, treatment algorithms, and/or modified office protocols have shown to increase mental health screening [ 16 , 35 , 44 ]. While these efforts remain on a local level, our study suggested that annual wellness visits correlate with increased screening rates.…”

Section: Discussionmentioning

confidence: 99%

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care

Müller,

Abdelnour,

Rutaremara

et al. 2024

PLoS ONE

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Background Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. Design In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. Results In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6–80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80–1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62–1.77), frequent visits (aOR 1.80; 95% CI, 1.78–1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47–1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). Discussion The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates.

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Section: Discussionmentioning

confidence: 99%

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care

Müller,

Abdelnour,

Rutaremara

et al. 2024

PLoS ONE

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Improving Person-Centered Depression Screening and Care in an Urban Faith-Based Community

Michoma,

Couch

2024

J Doct Nurs Pract

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Background:Depression is a common mental illness that increases the risk of suicide, substance abuse, and chronic pain. Nationally, 21 million adults have had one untreated depressive episode, 1.4 million people have had suicide attempts, and 1 death occurs every 10 minutes. Depression has an annual economic burden of $326 billion for the American economy.Objectives:This quality improvement project aims to review the existing literature on depression, audit local businesses, survey clients, and team members to identify a gap in practice and then collect and analyze data to draw conclusions and make recommendations based on the findings.Methods:This initiative used four Plan–Do–Study–Act rapid quality improvement cycles. Data were collected and analyzed, and the results were used to make iterative changes.Results:Depression screening improved by 90%, and 317 clients were screened over 8 weeks. Twenty-eight percent of those screened had depression and were engaged in managing their symptoms. Both screening and care improved, and the aim of 89% was met.Conclusions:This initiative bridged a gap in depression screening and care. It also demonstrated a positive outcome, had the potential for sustainability, and spread to other faith communities.Implications for Nursing:A system should be put in place for depression screening, care, and referrals.

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Improving Depression Screening in Primary Care

Cited by 2 publications

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Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care

Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care

Improving Person-Centered Depression Screening and Care in an Urban Faith-Based Community

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