Year of Publication
Doctor of Nursing Practice
Dr. Elizabeth Tovar
Dr. Sharon Lock
Background: Within primary care patients identified with depression often do not receive appropriate care (43%). Guidelines recommend combining pharmacotherapy and psychotherapy when possible and establishing follow up with patients to improve their response to treatment According to the APA, only 10% of patients receive combination therapy.
Purpose: The purpose of this study was to evaluate depression management practices in a primary care clinic, describe providers’ attitudes and skills related to depression treatment, and work with the healthcare team to identify strategies to improve depression management within the clinic.
Methods: A single site, descriptive study utilized a retrospective chart review of 115 patients with a PHQ-9 score greater than or equal to 10. A provider questionnaire assessed perceptions and attitudes of depression management and identified barriers to management in current practice.
Results: Of the 115 patient charts, the average PHQ-9 score was 14.7 (SD=3.9). Based on guideline recommendations, 100% of visits would have expected combined therapy and documentation of follow-up within four weeks. However, 43% of patient visits had documentation for combined treatment, 58% of visits had a follow up for the patient, and the average time frame was 6.5 weeks. The top barrier identified to depression management was lack of availability of mental health services (M=4.00, SD=1.12).
Conclusion: This clinic is providing appropriate management when compared to national statistics. Areas of improvement include increasing documentation of behavioral health discussion and follow-up and decreasing follow-up time frame. Availability of mental health services is being improved with the integration of behavioral health and family medicine.
Amos, Danica, "Evaluating Depression Management in Primary Care" (2019). DNP Projects. 260.