DescriptionPurpose of Project: Depression affects more than 300 million people globally and is the most common mental health condition in primary care. Despite its prevalence, only about 50% of depressed patients are identified. This quality improvement project assessed the impact of implementing the Patient Health Questionnaire- 9 (PHQ-9) in a primary care practice to help identify depression in patients.
Methodology: A quality improvement model using PHQ-9 screening was implemented as standard of care for all new patient visits and all patients seen for annual visits. Chart review data was used to measure changes in screening rates. Records of new patient visits and annual wellness visits were reviewed 3-months prior to implementation and for 3-months post-implementation to identify the number of patients who were screened for depression using the PHQ-9.
Results: During the pre-implementation period, out of 160 eligible patients, 4 were assessed for depression, resulting in 3 patients being diagnosed with depression and referred for treatment. During the post-implementation period, out of 154 eligible patients, 88 were screened using the PHQ-9, resulting in 6 patients being diagnosed with depression and referred for treatment. Overall, there was a 54.5% increase in depression screening rates [X2 (1) = 80.71, p <.001].
Conclusions: This quality improvement project demonstrated a significant improvement in depression screening with the use of the PHQ-9 screening tool. It is an effective tool in helping to identify, diagnose, and treat depression in primary care.
Implications for Practice: The implementation of PHQ-9 into the standard of care at primary care practices can positively affect identification, diagnosis, and treatment of depression in patients. The early identification and treatment of depression with the PHQ-9 can decrease healthcare costs and positively influence the economy.