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Program benefited PCPs treating adolescent depression
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A depression screening and treatment program increased feelings of comfort and accountability among primary care providers treating depression in adolescents, according to study findings in Clinical Pediatrics.
Jonathan M. Libby, DNP, APRN, CPNP, of the University of Massachusetts in Boston, and colleagues assessed the comfort levels of PCPs when administering depression-screening tools, Patient Health Questionaries-2 (PHQ-2) and PHQ-9. PCPs were from an outpatient pediatric clinic in Maine. The PHQ-2 and PHQ-9 were integrated into the current electronic medical record as part of the template for children aged 12 to 18 years. Researchers explained how PHQ-2 and PHQ-9 functioned and explained grading to providers. Providers then used the screening tool (n=12) and treated necessary patients (n=4). Additionally, treatment providers completed surveys before and after study participation, which assessed their experience with the study.
Providers administered PHQ-2 to every child, aged 12 to 18 years, at their annual physical exam. If a child scored 3 or higher, PHQ-9 was administered. A positive score on PHQ-9 warranted a follow-up visit with a member of the treatment team. Follow-up visits were 15 minutes long every week for 2 weeks and then occurred monthly for 3 months.
Overall, 264 physical exams were conducted during the study period. Twelve children scored 3 or higher on PHQ-2. Those with a score of 3 or higher had a mean age of 15.2 years. PHQ-9 was administered to children with a score of 3 or higher, and resulted in 12 positive scores for depression. Eleven children were referred for cognitive behavioral therapy, one was referred to a mental health specialist and four started a selective serotonin reuptake inhibitor.
Providers’ comfort levels increased by 60% after study participation. Feelings of accountability increased by 63%. Seventy-five percent of providers felt that 30 minutes was enough time for an initial depression visit if the PHQ-9 was already completed and graded.
“These results demonstrate that an evidence-based depression screening protocol and clinical toolkit can be implemented in a primary care setting. With the repeated use of a clinical toolkit and exposure to depression, PCPs can increase their confidence in their ability to screen for, treat, and refer adolescents with depression and in turn their feelings of accountability,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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