Implementing a Comprehensive Diabetes and Depression Program at Family Health Care

The purpose of this project was to improve outcomes of patients with type 2 diabetes and depression at a federally qualified healthcare center (FQHC) primary care clinic by creating and implementing a functional, sustainable and collaborative program facilitated by the diabetic educator, clinical pharmacist, and primary care. Expectantly, participants of the Comprehensive Diabetes and Depression Program (CDDP) would have better control of their chronic diseases, as well as improved satisfaction, activation and self-efficacy. The CDDP was implemented in February 2016 and data was collected until January 31, 2017. The FQHC providers and staff were educated on the importance of depression screening, detection, and management in all type 2 diabetic patients. The FQHC personnel were given a pre-implementation survey to gain their thoughts and concerns towards implementing the CDDP, as well as a six-month post-implementation survey. There was a decrease in FQHC staff and provider participation with the six-month post-implementation survey, however, the results received showed staff satisfaction was virtually unchanged from the pre-implementation survey. All patients with type 2 diabetes were screened for depression at every clinic visit using the Patient Health Questionnaire (PHQ-9). Any patient with a PHQ-9 of 10 or higher was referred to the CDDP to meet with a clinical pharmacist to discuss lifestyle changes and possible medication adjustments. Once enrolled into the CDDP, patients were administered a Patient Activation Measure (PAM) survey to identify their level of health activation, that was repeated after six months. As of January 31, 2017, only one patient had completed their six-month PAM survey, which showed a slight decline in their score. However, over a 100% increase was seen in the number of patients with type 2 diabetes who were referred to the clinical pharmacist, qualified for the CDDP, and referred specifically for the CDDP