Tiemstra Jeffrey D, Fang Kexin
Aurora Health Care, Elkhorn, WI and University of Illinois at Chicago College of Medicine.
Fam Med. 2017 Jan;49(1):42-45.
Screening for depression in primary care can be effective, but ensuring that appropriate care is available and engaging patients in treatment are major challenges. Even when follow-up care is available, patient engagement often relies on the primary care provider initiating care. In this study we wanted to assess the effectiveness of a depression screening program in an academic family practice.
Depression screening occurred in 98.4% of all adult encounters (n=3,341). Of these patients, 7.3% screened positive for depression and were not presenting for mood problems. Only 33.7% of patients with positive screens had their results addressed. Patients who had their results addressed were twice as likely to return for follow-up as those who did not (34.1% versus 17.4%). Patients with severe depression were more likely to follow-up than patients with mild depression (53% versus 15%).
Depression screening occurred in 98.4% of all adult encounters (n=3341). Of these patients 7.3% screened positive for depression and were not presenting for mood problems. Only 33.7% of patients with positive screens had their results addressed. Patients who had their results addressed were twice as likely to return for follow-up as those who did not (34.1% vs. 17.4%, P<.01). Patients with severe depression were more likely to follow-up than patients with mild depression (53% vs. 15%, P<.01).
Depression screening can be efficiently incorporated into primary care practice, but engaging providers and patients in diagnosis and treatment is challenging. We recommend a systems-based approach that emphasizes immediate access to treatment when implementing depression screening in a primary care practice.
在初级保健中筛查抑郁症可能是有效的，但确保提供适当的护理以及促使患者参与治疗是主要挑战。即使有后续护理，患者的参与往往依赖于初级保健提供者启动护理。在本研究中，我们想评估一项抑郁症筛查项目在学术性家庭医疗中的效果。
在所有成人诊疗中，98.4%（n = 3341）进行了抑郁症筛查。在这些患者中，7.3%抑郁症筛查呈阳性且未表现出情绪问题。筛查呈阳性的患者中，只有33.7%的患者得知了结果。得知结果的患者返回进行随访的可能性是未得知结果患者的两倍（34.1%对17.4%）。重度抑郁症患者比轻度抑郁症患者更有可能进行随访（53%对15%）。
在所有成人诊疗中，98.4%（n = 3341）进行了抑郁症筛查。在这些患者中，7.3%抑郁症筛查呈阳性且未表现出情绪问题。筛查呈阳性的患者中，只有33.7%的患者得知了结果。得知结果的患者返回进行随访的可能性是未得知结果患者的两倍（34.1%对17.4%，P <.01）。重度抑郁症患者比轻度抑郁症患者更有可能进行随访（53%对15%，P <.01）。
抑郁症筛查可以有效地纳入初级保健实践，但促使提供者和患者参与诊断和治疗具有挑战性。我们建议采用一种基于系统的方法，即在初级保健实践中实施抑郁症筛查时强调立即获得治疗。
