Improving Depression Screening in Primary Care.

Area of Science:

• Healthcare Improvement
• Primary Care Medicine
• Mental Health Services

Background:

• Depression is a significant health issue in the US, often underdiagnosed and undertreated.
• It negatively impacts chronic illness, healthcare use, and can be fatal.
• Primary care settings are ideal for early depression screening and intervention.

Purpose of the Study:

• To enhance the diagnosis and treatment of depression in an adult primary care setting.
• This evidence-based practice project aimed to improve patient outcomes through systematic screening and treatment protocols.

Main Methods:

• An intervention was implemented, including a HealthWatcher reminder for depression screening.
• The PHQ-9 (Patient Health Questionnaire-9) instrument and a treatment algorithm were integrated into the office workflow.
• Pre- and post-intervention random samples of patient charts were compared to assess changes in screening and treatment rates.

Main Results:

• The post-intervention depression screening rate was significantly higher than the pre-intervention rate (90% vs. 23.3%).
• Statistical analysis (chi-squared test) confirmed the significant improvement in screening rates (χ² = 54.3, df = 1, P < .000).

Conclusions:

• Modifying office protocols can effectively improve depression diagnosis and treatment in primary care.
• The use of the PHQ-9 screening tool and a standardized treatment algorithm is feasible and beneficial for adult patients.
• This approach demonstrates a successful strategy for addressing underdiagnosis and undertreatment of depression in primary care settings.