Improving Screening and Treatment of Depression in a Primary Care Clinic using an Evidence-Based Protocol

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LaValle, Nicole
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Purpose: Implement the PHQ-9, an evidence-based depression screening tool, followed by a unique toolkit to provide evidence-based depression management in a primary care clinic.|Background: Depression is more than a mental illness. It can cause chronic co-morbidities, complex patient care, disability, financial and social burden, and suicide. Recognizing risk factors for depression is necessary to provide adequate treatment and remission. One out of five Americans struggle with depression, however, only 8.5% of primary care office visits include depression screening in adults. The provider’s role in screening and management of depression needs improvement and should acknowledge the severity depression has on an individual’s life.|Sample/Setting: The sample population are the providers at a suburban clinic in Big Lake, MN.|Methods: The overall goal of the QI project was to address the depression screening rates at the primary care clinic, provide education to providers, identify barriers to screening and treatment of depression, and to improve screening rates and management of depression. The PHQ-9 was used to screen for depression for this QI project.|Results: In comparison of 13 weeks prior to project implementation to the 13 weeks of the project, one provider went from 63/243 (25.9%) of routine PHQ9 screenings not addressed in patients who were due to 50/295 (16.9%) of routine PHQ9 screenings not addressed. Therefore, depression screening rates improved amongst those who were due for routine screening of the PHQ9 at office visits by 9% in the period of this QI project in the provider who participated.|Conclusion: Depression has many negative impacts on our communities and can be difficult for patients to talk about due to unnecessary negative social stigma. It is important that providers are educated on the use and implementation of the PHQ9 screening tool in their daily practice to improve screening and access to depression management.
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