Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Dr. Michelle Pendleton

Committee Member

Dr. Julianne Ossege

Abstract

BACKGROUND: Depression in adults with type 2 diabetes can lead to non-adherence to self-management behaviors and treatment recommendations, and ultimately worse health outcomes. Currently, only 50% of adult patients with type 2 diabetes treated in the primary care setting are screened for depression. Without screening for depression, a diagnosis of depression and subsequent treatment is likely to be missed and the patient is more likely to experience worse health outcomes and worse quality of life.

PURPOSE: The purpose of this study was to evaluate impact of provider education on improving screening rates for depression in adult patients with type 2 diabetes within the primary care setting. The objectives of this study were to: 1. Evaluate baseline assessment of screening rates using the PHQ 2/9 by providers, and provider knowledge, facilitators, and barriers regarding screening for depression in adult patients with type 2 diabetes in primary care;

2. Deliver an education intervention to providers on the importance of screening adult patients with type 2 diabetes in the primary care setting.; and 3. Evaluate changes in depression screening rates using the PHQ 2/9 post educational intervention.

METHODS: This study used a quasi- experimental design. Phase 1 consisted of an online provider survey to assess knowledge, facilitators, and barriers in screening adult patients with type 2 diabetes for depression. Phase 2 included a provider educational intervention with pre and post chart reviews to assess depression screening rates.

RESULTS: There was a significant increase in screening from 1.9% to 6.3% (p = .024) after the educational intervention. Barriers to screening identified included time to screen, and knowledge of documentation in the EHR.

CONCLUSION: Providers agree that screening for depression in adult patients with diabetes is important and they feel comfortable with screening. Further work is needed to identify measures that will continue to increase and sustain depression screening for adult patients with type 2 diabetes in the primary care setting.

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