Initiating Consistent PHQ-9 Depression Screening Among Adolescents in a Rural Primary Care Clinic: A Quality Improvement Project
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Depression , Adolescents , Screening
Adolescent depression has significantly increased within the last decade. Depression among the youth population is often not identified, with as many as two-thirds of the cases not diagnosed by their primary provider. The Patient Health Questionnaire-9, or the PHQ-9, is a highly sensitive screening form used to identify and monitor depression symptoms in adolescents. The PHQ-9 screening form and educational video were incorporated into all adolescent well visits and sports physicals in a rural Iowa clinic in an effort to increase the number of adolescents screened and treated for depression. A total of five adolescents watched an educational video and were screened with the PHQ-9. No interventions were warranted given the low depression severity scores. However, the number of screenings were increased with a screening completion rate of 100%. The provider verbalized positive feedback and hopes to continue the process change within the clinic. Routine screening for adolescent depression is essential in primary care in order to identify and treat symptoms early and prevent lifelong effects, especially in rural settings where mental health services are scarce.
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