Depression Screening in an Academic Family Practice.

BACKGROUND AND OBJECTIVES Screening for depression in primary care can be effective, but ensuring that appropriate care is available and engaging patients in treatment are major challenges. Even when follow-up care is available, patient engagement often relies on the primary care provider initiating care. In this study we wanted to assess the effectiveness of a depression screening program in an academic family practice. RESULTS Depression screening occurred in 98.4% of all adult encounters (n=3,341). Of these patients, 7.3% screened positive for depression and were not presenting for mood problems. Only 33.7% of patients with positive screens had their results addressed. Patients who had their results addressed were twice as likely to return for follow-up as those who did not (34.1% versus 17.4%). Patients with severe depression were more likely to follow-up than patients with mild depression (53% versus 15%). RESULTS Depression screening occurred in 98.4% of all adult encounters (n=3341). Of these patients 7.3% screened positive for depression and were not presenting for mood problems. Only 33.7% of patients with positive screens had their results addressed. Patients who had their results addressed were twice as likely to return for follow-up as those who did not (34.1% vs. 17.4%, P<.01). Patients with severe depression were more likely to follow-up than patients with mild depression (53% vs. 15%, P<.01). CONCLUSIONS Depression screening can be efficiently incorporated into primary care practice, but engaging providers and patients in diagnosis and treatment is challenging. We recommend a systems-based approach that emphasizes immediate access to treatment when implementing depression screening in a primary care practice.