Implementing of Depression Screening: Primary Care Clinic Serving a Culturally Diverse Population

In 2016, the United States Preventative Services Task Force recommended screening adults in primary care clinics that have the capacity to effectively treat depression. Hispanic adults have experienced barriers to the identification and treatment of depression but maintain a high rate of lifetime prevalence. A depression screening protocol was introduced at a primary care clinic in central Utah that sees a high number of Hispanic patients. Screening was performed at every adult patient encounter over a 2-month period. Screening was performed verbally by medical assistants as part of the rooming process. Every positive response was met with a request to complete a PHQ-9 to quantify symptoms and potentially diagnose depression. Of interest was the identification of depression in patients with no known history and a non-depression related chief complaint. A chart review was done to compare screening rates pre- and post-intervention, depression diagnoses, and analyze effects on demographic subgroups. The intervention increased the rate of positive screens from 13.5% to 35%. Depression was diagnosed at 18.8% of encounters in which screening was performed and 14 cases of novel depression were identified. The majority of novel cases were found in Hispanic patients. Subgroup analysis showed Caucasian patients were 2.5 times more likely to be diagnosed with depression due to screening when compared to Hispanic patients. There was not a significant difference between men and women and people under 40 and those over 40. Implementation of a screening protocol in a primary care clinic did increase the identification of depression among the population. Responses from Hispanic patients were mixed creating more clinical questions. Implementation of screening caused an impact on all clinical staff and additional door-to-door time for patients