Implementation of the Generalized Anxiety Disorder 7-Item (Gad-7) in an Integrated Primary Care Setting

Purpose: The GAD-7 is an effective, validated tool that screens adults for generalized anxiety disorder, allowing for timely diagnosis, treatment initiation, and behavioral health referral. A quality improvement project was designed to educate primary care providers at an integrated, community health clinic on the indication, use, and interpretation of the GAD-7.Background: Generalized anxiety disorder is a common condition that can have widely detrimental effects. Consistent use of the GAD-7 in primary care settings can mitigate anxiety-related dysfunction, reducing tertiary care interventions, lowering spending, and improving patient outcomes. The GAD-7 facilitates measurement-based care, which optimizes diagnostic speed and accuracy, and facilitates high-quality care. The clinic implemented the GAD-7 as a standard of primary care to address gaps in anxiety assessment and integrative care practices. Methods: Twenty primary care providers were recruited through convenience sampling and educated during an in-service, evidence-based presentation. The participants completed pre- and post-intervention surveys that assessed existing and subsequent GAD-7 knowledge and use. Descriptive statistics were used to analyze and interpret the survey data. Results: Post-intervention, most participants reported that the GAD-7 would improve their ability to assess patients for anxiety and identify those who require further treatment. All participants reported that the GAD-7 would improve their ability to identify patients for behavioral health referral. Conclusions: The education presentation effectively improved GAD-7 knowledge and perception among the primary care providers. Increased provider knowledge enables successful GAD-7 implementation as part of routine, measurement-based care at the clinic. Continued GAD-7 use will improve outcomes for patients and the clinic, reducing a significant gap in integrative care delivery. Keywords: measurement-based care, generalized anxiety disorder, GAD-