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在基层医疗环境中对青少年实施焦虑筛查的可行性与有效性

Feasibility and Effectiveness of the Implementation of Anxiety Screening for Adolescents in a Primary Care Setting.

作者信息

Soliman Mario, Petrovic-Dovat Lidija, Logan Jeanne M, Fogel Benjamin N

机构信息

Family Medicine, University of Pittsburgh Medical Center Pinnacle, Lititz, USA.

Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, USA.

出版信息

Cureus. 2024 Jul 12;16(7):e64409. doi: 10.7759/cureus.64409. eCollection 2024 Jul.

Abstract

The United States Preventive Services Task Force recommended routine anxiety screening for children and adolescents in 2022. This study describes the feasibility of routine anxiety screening in a primary care practice. It further examines the effects of routine anxiety screening on anxiety diagnoses and provider behavior in a setting in which anxiety screening was implemented five years in advance of the national guidelines. During the first year of implementation, approximately 80% of patients were screened, and 17% of screens were positive. A retrospective chart review of patients with positive screens found that the majority of positive screens led to a new diagnosis of anxiety and that half of newly diagnosed patients were prescribed an intervention. Screening was associated with an increase in diagnoses of anxiety disorders in the studied population from 9.6% to 13.3% (p<0.0001). Following the initial implementation, screening rates continued to rise, with an eventual plateau of >90%. Anxiety screening in the pediatric primary care setting is feasible and sustainable and led to increased provider recognition of anxiety and meaningful clinical action.

摘要

美国预防服务工作组在2022年建议对儿童和青少年进行常规焦虑筛查。本研究描述了在初级保健实践中进行常规焦虑筛查的可行性。它进一步探讨了在比国家指南提前五年实施焦虑筛查的环境中,常规焦虑筛查对焦虑症诊断和医疗服务提供者行为的影响。在实施的第一年,约80%的患者接受了筛查,其中17%的筛查结果呈阳性。对筛查结果呈阳性的患者进行回顾性病历审查发现,大多数阳性筛查结果导致了新的焦虑症诊断,且一半新诊断患者接受了干预治疗。筛查与研究人群中焦虑症的诊断率从9.6%提高到13.3%相关(p<0.0001)。在最初实施后,筛查率持续上升,最终稳定在90%以上。儿科初级保健环境中的焦虑筛查是可行且可持续的,并提高了医疗服务提供者对焦虑症的认识以及采取了有意义的临床行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a42c/11317120/df1cb37ed937/cureus-0016-00000064409-i01.jpg

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