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Nearly 1 in 4 older patients not screened for depression
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Approximately 25% of physician-patient encounters at an academic outpatient geriatrics practice did not result in depression screening and follow-up, even though doing so is recommended by the U.S. Preventive Services Task Force, according to data presented at the American Geriatrics Society Annual Scientific Meeting.
Abstract author Kelly Cummings, MD, geriatric medicine fellow at Mount Sinai Health System in New York City, told Healio Primary Care Today that the reasons for the research were twofold.
“First, depression screening and appropriate referral is a quality measure for the Merit-based Incentive Payment System and we wanted to better investigate provider screening practices to improve our metrics,” she said.
“Second, referrals to our practice’s team-based ‘Improving mood and promoting access to collaborative treatment’ (IMPACT) program that integrates depression treatment into primary care were lower than expected, so we decided to look into if referrals were low possibly due to inadequate depression screening process,” Cummings continued.
Researchers reviewed 1,913 encounters between patients aged 65 years and older and physicians. They found that overall, 77.6% had a depression screening involved. Among providers within the practice, screening rates varied from 46.7% to 90.3%.
Cummings suggested possible ways to improve screening rates even though office visits are finite.
“Improving depression screening in a primary care geriatrics practice needs to become a collaborative team effort. Interventions aimed at involving and re-educating all team members, from the medical assistants to the providers to the social workers, can help improve screening rates and lead to improved treatment and decrease the morbidity associated with untreated depression,” she said in the interview.
For their part, Cummings and colleagues wrote that they hoped to increase depression screening rates within their location by using the Plan-Do-Study-Act technique: creating a plan to test the change (Plan), carrying out the test (Do), watching and learning from the consequences (Study), and ascertaining what modifications should be made to the test (Act), according to the Institute for Healthcare Improvement. – by Janel Miller
References:
Depression screening and follow-up in older adults at an academic geriatrics practice: A needs assessment. Presented at: American Geriatrics Society Annual Scientific Meeting. May 2-4, 2019, Portland, Oregon.
Also: IHI.org. “Plan. Do. Act. Study. Worksheet.” http://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx. Accessed May 14, 2019.
Disclosures: Cummings reports no relevant financial disclosures. Healio Primary Care Today was unable to confirm the other authors’ relevant financial disclosures prior to this story’s posting.