Psychiatric Nurse Department of Behavioral Health Columbia, Maryland, United States
Abstract : Abstract Problem: Depression is a major mental health concern as it affects 5% of adults worldwide and in the United States (US). This condition resulted in over 49,000 suicide-related deaths in the US in 2022; as such, timely diagnosis and treatment are essential to improving the quality of life and in preventing suicide in patients with depression. The practice problem at the outpatient behavioral health clinic was the utilization of semi-structured interviews to identify depression which is less sensitive and specific when compared to evidence-based depression screening tools, which increases the risk of unrecognized and untreated depression. Notably, in the last quarter of 2023, 60% of patients at the project site were diagnosed with depression on their subsequent and not initial visit.
Purpose: To utilize Patient Health Questionnaire (PHQ) PHQ -2 and PHQ-9 depression screening tools to improve early detection and treatment of depression among new adults and adolescents visiting the clinic.
Methods: This QI project, implemented over 15 weeks targets about 300 new adolescent and adult patients using PHQ-2 and PHQ-9 depression screening tools. All 22 staff received training on the screening process prior to its implementation. New patients complete the PHQ-2 questionnaire at their initial visit, and those scoring two or higher proceed to be screened with the PHQ-9. If the patient scores 10 or above on the PHQ-9, the clinician is alerted, confirms the diagnosis and determines appropriate treatment. Patients scoring 5-9 undergo annual screenings, following USPTF guidelines. The PL collects data from the EHR weekly and inputs it into REDCap survey. Preliminary
Results: 72/89 patients were eligible, and 100% of eligible patients were screened over the four weeks. Of these, 33 required further intervention based on PHQ-9 scores. In week one, 46% had scores above 9, increasing to 67% by week four. Overall, 47% of patients screened had moderate to severe depression. Data results are shared with stakeholders during weekly meetings conducted by the PL. Preliminary
Conclusions: Preliminary results indicates that the intervention is making a meaningful impact, and the project is on track to improve depression screening at the clinic. The PHQ-2 and PHQ-9 screening tools effectively identifies at-risk patients, highlighting the importance of routine screening for timely diagnosis and treatment of depression.
