Date Available

4-25-2023

Year of Publication

2023

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Dr. Lori Fugate

Committee Member

Dr. Julianne Ewen

Abstract

Background: Nearly one-third of patients diagnosed with depression and prescribed an antidepressant medication will stop taking their medication within the first month. Timely follow-up care can improve medication adherence and symptoms for depressed patients on antidepressants however, most patients do not receive timely follow-up. Common system and provider-based barriers to timely follow-up include limited provider time, lack of training, and mental health stigma.

Objective: The purpose of this project was to assess provider attitudes, knowledge level, perceived barriers, and current depression management strategies in a primary care setting.

Methods: In this quasi-experimental one group pre/post-test study a survey was used to assess provider attitudes, knowledge level, and barriers related to managing depression before and after an educational intervention. All providers practicing primary care in a central Kentucky (a total of 10 Physicians and APRNs) were invited to participate via email. The intervention consisted of an asynchronous narrated online PowerPoint presentation describing the recommended guidelines for depression management.

Results: 50% of providers participated (5 providers, 100% female). There was a non-significant increase in confidence in diagnosing depression in primary care after the educational intervention (pre, Mean=4.6 vs. post, Mean 5.0, p=.18). There was a non-significant increase that providers were more likely to prescribe antidepressants for a PHQ-9 score greater than 10 (pre, Mean=3.6 vs. post, Mean=4.6, p=.09). Barriers identified were not having enough time to care for the patient and limited schedule availability for follow-up appointments.

Conclusions: Providers found the education helpful and will change their practice based on the algorithm of care presented in the educational intervention. It is recommended moving forward, that providers are trained in depression management and for the clinic team to select a guideline and follow it to standardize depression care within the clinic. Options should be explored to improve appointment availability, such as the use of Telehealth, to increase access to care.

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