Depression Screening in the Primary Care Setting

Recent data reveals that approximately 17.3 million adults in the US population experience an episode of depression each year. Unidentified and untreated depression has many consequences leading to a poor quality of life, direct and indirect healthcare cost-related increases, and an increase in medical comorbidities. The U.S. Preventative Services Task Force recommends that all adults be screened for depression. The PHQ-2 and PHQ-9 are the most widely accepted screening tools in the preliminary detection of depression. The purpose of this project was to educate health care professionals regarding depression and the implementation of a new depression screening protocol: A positive PHQ-2, would trigger the immediate administration of the PHQ-9, possibly leading to prompt intervention. The population used in this study were adults aged 18-99, medically underserved, and predominantly African American. Data collected to evaluate the protocol included: rates of administering the PHQ-2 and PHQ-9 prior to and after an educational in-service, the number of patients identified with depression with comparison of the clinic’s previous and new depression screening protocol, and the clinic’s reimbursement after proper coding for these screenings. There was a 33% increase in the PHQ-2 screening (n=145); 100% of patients (n=22) with positive PHQ-9 screening for depression were immediately treated or referred for treatment. The results of this project demonstrate that the clinic members accepted and implemented this new protocol, more effectively identifying patients with depression, promptly referring for treatment, and billing for services