Improving Parkinson's Disease Care through Systematic Screening for Depression.

Area of Science:

• Neurology
• Psychiatry
• Clinical Practice Improvement

Background:

• Depression is a prevalent yet underrecognized comorbidity in Parkinson's disease (PD).
• Systematic screening is recommended for depression in PD care but is not widely adopted.
• Current clinical practice often lacks formal depression assessment tools for PD patients.

Purpose of the Study:

• To assess the feasibility and impact of implementing a formal depression screening tool in movement disorder clinics for Parkinson's disease patients.
• To evaluate the increase in formal depression screening rates and identify barriers to implementation.
• To examine the effect of screening on depression scores in PD patients.

Main Methods:

• The 15-item Geriatric Depression Scale (GDS-15) was implemented across 5 movement disorder clinics.
• Site-specific workflows were developed, and qualitative interviews were conducted with clinicians and patients.
• Screening rates, reasons for non-screening, and depression scores were analyzed before and after implementation.

Main Results:

• Formal screening increased nearly five-fold, with 88% of PD patients screened during the study period.
• The Geriatric Depression Scale (GDS-15) was used in 59% of screenings, a substantial rise from baseline.
• 45% of patients completing the GDS-15 screened positive for depression, and subsequent follow-up showed significant improvements in depression scores.

Conclusions:

• Formal depression screening using instruments like the GDS-15 is achievable at higher rates in Parkinson's disease care.
• Barriers such as clinician time and logistical challenges exist but can be managed with site-specific processes.
• Optimizing screening rates requires tailored implementation strategies for individual clinical settings.