Screening for Anxiety in the Primary Care Setting

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Portillo, Sarah
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Background: In the United States, the burden of mental illness is among the highest of all diseases, and mental disorders are a common cause of disability (Healthy People, 2020). Approximately one in five adults has a mental health disorder with the most common two disorders being anxiety or depression (Healthy People, 2020). Undiagnosed and subsequently untreated anxiety can cause significant morbidity and mortality. Even though anxiety is highly prevalent, the rates of diagnosis and treatment of anxiety disorders are lower than expected (Buszewicz, 2011). Most patients who are experiencing anxiety will be seen in the primary care setting.|Problem: Anxiety is a significant cause of morbidity and mortality but continues to be underdiagnosed and undertreated due to lack of screening in the primary care setting. Identifying and addressing barriers that prevent patients from seeking treatment regarding anxiety and that prevent providers from routinely assessing for anxiety is necessary for prompt diagnosis and treatment. Purpose: The purpose of this proposed quality improvement project was to implement a process for anxiety screening in the primary care setting using the GAD-7. Providers were surveyed to determine the feasibility and sustainability of using the GAD-7 to screen for anxiety.|Methods: This DNP quality improvement project was conducted at a small local clinic in El Paso, Texas over a 9-week period. The GAD-7, anxiety screening tool, was used to identify patients who are experiencing anxiety to ensure appropriate treatment or referral. Providers and medical assistants were provided with educational material regarding the signs and symptoms of anxiety as well as screening for anxiety. Providers were surveyed to determine the feasibility and sustainability of using the GAD-7 to screen for anxiety in the primary care setting.|Conclusion(s): Providers felt that they did not have sufficient time to address anxiety with their patients and that the screening tool was not effective for their practice. When patients screened positive for anxiety and required intervention, the amount of time providers spend with the patients increased significantly.
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