Title: Improving depression identification and treatment using PHQ-2 and PHQ-9 screening tools
Abstract:
Problem: Depression is a mental health concern in the United States (U.S), impacting 18.4% adults in 2020. In 2022, there were approximately 49,000 suicide-related fatalities underscoring the need for early diagnosis and treatment of depression to improve the quality of life and reduce suicide rates. An outpatient behavioral health clinic used semi-structured interviews to screen for depression, which is less sensitive and specific compared to evidence-based depression screening tools, increasing the likelihood of undiagnosed and untreated depression.
Purpose: The purpose of this quality improvement (QI) project is to improve the early detection and treatment of depression among adolescents and adults in a behavioral clinic by implementing the Patient Health Questionnaire (PHQ) PHQ -2 and PHQ-9 depression screening tools.
Methods: This QI project, implemented over 15 weeks, targets about 300 adolescent and adult patients. All 22 staff received training on the depression screening process prior to its implementation. New patients completed the PHQ-2 questionnaire at their initial visit, and those scoring two or higher proceeded to be screened with the PHQ-9. If the patient scored 10 or above on the PHQ-9, the provider was alerted, prompting further evaluation and treatment if deemed clinically necessary. Patients scoring five to nine will undergo annual screenings, following USPTF guidelines. Data results are shared with stakeholders during weekly meetings conducted by the project leader (PL). The monthly competition was held by the PL, and the staff who screened the most were awarded a certificate Motivational quotes were displayed throughout the clinic to foster staff engagement.
Preliminary Results: All eligible patients (72/89) were screened using the PHQ-2 and PHQ-9 over four weeks. Patients who scored 5-9 on the PHQ-9 (17.65%) were scheduled for annual screening, while 52.94% received further interventions.
Preliminary Conclusions: Preliminary results indicate that the PHQ-2 and PHQ-9 are feasible depression screening tools that aid in the timely diagnosis and treatment of depression. The adoption of these tools could yield positive effects, including earlier detection and treatment of depression, reduced suicide rates, improved patient outcomes, and decreased healthcare costs.
