Date on Paper
7-2024
Document Type
Doctoral Paper
Degree Name
D.N.P.
Department
Nursing
Committee Chair
Volpert, Elisabeth
Committee Member
Riff, Diane
Author's Keywords
depression; follow-up care; quality improvement; primary care; Patient Health Questionnaire-9 (PHQ-9); mental health
Abstract
Background: Depression is a prevalent condition requiring systematic approaches for effective treatment and follow-up in primary care. This quality improvement project aimed to enhance care for patients screening positive for depression at an academic family practice with a diverse patient population and a comprehensive electronic health record (EHR) system.
Purpose: The primary objective was to assess whether a provider educational session and the implementation of an optional depression treatment and follow-up algorithm could improve timely and appropriate care for patients with positive PHQ-9 screenings.
Setting: The project was conducted at an academic family practice office.
Methods/Procedures: The intervention included a provider educational session and the implementation of a depression treatment and follow-up algorithm. Data collection involved a pre-post comparison of metrics such as the number of patients screened, treatment initiation, follow-up interventions, and provider-reported algorithm use. Statistical analyses included chi-square tests to evaluate changes in treatment and follow-up rates across different PHQ-9 score categories.
Measures: Outcome measures included the number of patients screened for depression using the PHQ-9, treatment and follow-up rates, and demographic composition of patients receiving care.
Results: No significant improvements in treatment and follow-up care were observed post-implementation, with 62.5% (n=56) pre-implementation and 60.5% (n=38) post-implementation not receiving treatment for moderate PHQ-9 scores (10-14). The Chi-Square Test for Independence indicated no significant difference in treatment and follow-up rates before and after the intervention (p=0.841). However, notable shifts in demographic composition were observed, particularly among female patients and in racial representation.
Recommended Citation
Hooper, Jennifer D., "Improving treatment and follow-up care for patients who screen positive for depression in family practice: a quality improvement project." (2024). Doctor of Nursing Practice Papers. Paper 154.
Retrieved from https://ir.library.louisville.edu/dnp/154
