Battiola Tess, Ellison Tanner, Dummer Danica, Weir Rachel, Kaput Katie, Reddy Deepika
Endocrinology, University of Utah Health, Salt Lake City, Utah, USA
Medical Group Analytics, University of Utah Health, Salt Lake City, Utah, USA.
BMJ Open. 2025 Jan 11;15(1):e088973. doi: 10.1136/bmjopen-2024-088973.
To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.
Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.
University of Utah and University of Utah Health-affiliated primary care and specialty clinics.
Adults who screened positive for depressive symptoms (score≥10) on the Patient Health Questionnaire (PHQ-9) at an ambulatory visit between 1 January 2021 and 31 January 2022. A total of 17 651 patients were included in the study.
Follow-up for positive depression screens was defined as a new antidepressant prescription or completed mental health visit. Variables associated with follow-up included patient demographic data, anthropometric measures, geographical classification, primary language, comorbidities and socioeconomic factors as well as provider demographics, level of training and clinic type.
5396 patients (30.6%) did not receive follow-up care for a positive PHQ-9 screen. Factors associated with lower rates of follow-up included male patients (gender; p=0.013), older patients (age group; p=0.016), non-White patients (ethnicity; p<0.0001), non-English (primary language; p<0.0001), lack of insurance (p<0.0001), older providers (p=0.027), male providers (p=0.0037) and attending-level providers (p<0.0001).
Significant discrepancies in follow-up for positive depression screens in the ambulatory setting exist, particularly among racial/ethnic minority groups and patients who are non-native English speakers. Older providers and attending-level providers were less likely to facilitate follow-up for positive depression screens in their clinics.
确定与门诊环境中抑郁症筛查呈阳性的患者较低随访率相关的患者和医疗服务提供者因素。
采用回顾性队列研究并进行电子健康记录分析，调查与中重度抑郁症状患者后续护理相关的因素。患者和医疗服务提供者变量与抑郁症筛查呈阳性的随访率相关。
犹他大学及与犹他大学健康相关的初级保健和专科诊所。
在2021年1月1日至2022年1月31日期间的门诊就诊中，使用患者健康问卷（PHQ-9）筛查出抑郁症状呈阳性（得分≥10）的成年人。共有17651名患者纳入本研究。
抑郁症筛查呈阳性的随访定义为新开抗抑郁药处方或完成心理健康就诊。与随访相关的变量包括患者人口统计学数据、人体测量指标、地理分类、主要语言、合并症和社会经济因素，以及医疗服务提供者的人口统计学数据、培训水平和诊所类型。
5396名患者（30.6%）抑郁症筛查呈阳性但未接受后续护理。与较低随访率相关的因素包括男性患者（性别；p=0.013）、老年患者（年龄组；p=0.016）、非白人患者（种族；p<0.0001）、非英语患者（主要语言；p<0.0001）、缺乏保险（p<0.0001）、年长的医疗服务提供者（p=0.027）、男性医疗服务提供者（p=0.0037）和主治医师级别医疗服务提供者（p<0.0001）。
门诊环境中抑郁症筛查呈阳性的患者在随访方面存在显著差异，尤其是在种族/族裔少数群体和非英语母语患者中。年长的医疗服务提供者和主治医师级别医疗服务提供者在其诊所中促成抑郁症筛查呈阳性患者进行随访的可能性较小。
