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Creating a Clinical Care Pathway for Depressive Symptoms and Disorders in Long-Term Care: A Modified Delphi Process.
Kayla Atchison1, Andrea Gruneir2, Jason Sutherland3
1Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Journal of the American Medical Directors Association
|August 11, 2025
Summary
A clinical care pathway was developed to identify and treat depression in long-term care (LTC) residents. This pathway outlines steps for depression detection, management, and care coordination, aiming to improve resident well-being.
Area of Science:
- Geriatric Medicine
- Psychiatry
- Health Services Research
Background:
- Depression is prevalent in long-term care (LTC) residents, impacting their quality of life and health outcomes.
- Existing approaches to identifying and managing depression in LTC settings may be fragmented or inconsistent.
Purpose of the Study:
- To develop an evidence- and expert-informed clinical care pathway for the identification and treatment of depressive symptoms and disorders in LTC residents.
Main Methods:
- A modified Delphi survey was employed, involving LTC healthcare providers, administrators, family caregivers, and residents.
- Survey statements, based on evidence and expert opinion, were refined over multiple rounds to achieve consensus using Likert scale responses.
Main Results:
- Two survey rounds were needed to reach consensus among 26 participants.
- Statements were categorized into depression detection, identifying contributors, symptom management, and care coordination.
- Clinicians identified critical statements foundational to the pathway's function.
Conclusions:
- The generated pathway provides actionable steps for identifying and managing depression in LTC residents.
- Implementation of steps like staff education and access to non-pharmacologic treatments may require additional resources.
- Further research is needed to address disagreements on assessment timing, tool usage, and comorbidity management, and to understand implementation barriers.
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