Mount Saint Mary's University, Los Angeles, CA, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231152758. doi: 10.1177/21501319231152758.
Depression is a common mental health disorder faced by older adults that can go undetected and untreated. It was determined that the project site was not screening for depression among their older patient population. Aims: The purpose of this quality improvement project was to determine if the implementation of the Geriatric Depression Scale-15 (GDS-15) would impact the identification of risk factors for depression and follow-up among adults 65 and older.
Implementation started in June 2021 in a primary care office in Southern California. Data was collected for this project over a total of 8 weeks. This project was a quality improvement project designed to implement routine depression screening among older adult patients using the GDS-15. Depressive symptoms were identified, and follow-up and treatment for depression in primary care was initiated if indicated by GDS-15 scores. Data were obtained from the project site's electronic medical record on a total sample size of 443 patients (n = 252 in the comparison group and n = 191 in the implementation group).
A chi-square test indicated a clinical and statistically significant improvement in the identification rate of depression, X2 (1, N = 443) = 49.76, < .0001; and follow-up rate X2 (1, N = 70) = 23.94, < .0001. Clinical significance was found with an increase in the identification of depression and follow-up of older adults in primary care. Demographic variables were also compared for the QI intervention group patients according to those who scored <5 (n = 134) and patients who scored 5 or greater on the GDS-15 (n = 57) again using chi-square tests. The results showed significant differences between gender ( = .016) and primary diagnosis ( = .006).
Findings of this project suggest all older adults should receive a depression screening routinely in primary care to increase the recognition of depression as well as follow-up and treatment.
抑郁症是老年人常见的心理健康障碍，可能未被发现和治疗。据确定，项目现场未对其老年患者群体进行抑郁症筛查。目的：本质量改进项目旨在确定实施老年抑郁量表-15（GDS-15）是否会影响 65 岁及以上成年人中抑郁风险因素的识别和随访。
该项目于 2021 年 6 月在加利福尼亚州南部的一家初级保健办公室开始实施。本项目共收集了 8 周的数据。该项目是一项质量改进项目，旨在使用 GDS-15 对老年患者进行常规抑郁筛查。如果 GDS-15 评分表明存在抑郁症状，则启动初级保健中的抑郁随访和治疗。从项目现场的电子病历中获得了总共 443 名患者（对照组 n=252，实施组 n=191）的样本量数据。
卡方检验表明，抑郁识别率在临床和统计学上均有显著提高，X2（1，N=443）=49.76， < .0001；随访率 X2（1，N=70）=23.94， < .0001。在初级保健中，识别和随访老年人的抑郁情况有所增加，这具有临床意义。还根据 GDS-15 评分<5（n=134）和评分≥5（n=57）的患者对 QI 干预组患者的人口统计学变量进行了比较，再次使用卡方检验。结果显示，性别（ = .016）和主要诊断（ = .006）之间存在显著差异。
本项目的研究结果表明，所有老年人都应在初级保健中常规接受抑郁筛查，以提高对抑郁的认识，以及随访和治疗。
