Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre.
BACKGROUND
Depression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression.


METHODS
In this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age.


RESULTS
It was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period.


CONCLUSION
Standardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.
['Mansour|Mohamed|M|0000-0001-8960-6882', 'Krishnaprasadh|Dharshana|D|', 'Lichtenberger|Janice|J|', 'Teitelbaum|Jonathan|J|']
D000293:Adolescent D000294:Adolescent Behavior D002648:Child D003863:Depression D005260:Female D006768:Hospitals, Federal D006801:Humans D008297:Male D008403:Mass Screening D000073222:Patient Health Questionnaire D016730:Program Development D011795:Surveys and Questionnaires D014481:United States
quality improvement PDSA mental health