Improving PHQ9 Utilization Rates in a Primary Care-Mental Health Integration Setting

Area of Science:

• Mental Health
• Primary Care
• Quality Improvement

Background:

• Measurement-based care (MBC) is crucial for monitoring treatment but is underutilized in mental health.
• Primary care-mental health integration (PC-MHI) settings are key for implementing MBC.
• This study focuses on improving the use of the Patient Health Questionnaire-9 (PHQ9) in a PC-MHI setting.

Purpose of the Study:

• To describe a quality improvement (QI) process to enhance PHQ9 utilization in a PC-MHI setting.
• To increase baseline and 4-week follow-up PHQ9 administration rates to 90% for veterans with depression.

Main Methods:

• An educational intervention and weekly motivational enhancement sessions were implemented in 2017.
• Chart review data from fall 2016 and 2017 were used to compare PHQ9 utilization rates.
• The study focused on veterans diagnosed with a depressive disorder.

Main Results:

• Pre-intervention PHQ9 administration rates were 76% (baseline) and 35% (follow-up).
• Post-intervention, PHQ9 utilization increased to 98% at baseline and 88% at follow-up.
• The QI process significantly improved clinician adherence to MBC protocols.

Conclusions:

• A brief, education-based intervention effectively increased clinician use of MBC in a PC-MHI setting.
• The findings highlight the potential of targeted QI initiatives to improve mental healthcare delivery.
• Future research should evaluate the impact of MBC on actual treatment outcomes.