Utility of an intervention to detect depression in primary care

Objective: To determine whether a 3-part interventionconsisting of raising physicians’ awareness of depression,mass depression screening using a 2-item version of thePrime MD Questionnaire, and communicating the resultsof the screening to the physician, will improve detectionand treatment of depression in a primary care setting.Methods: The study took place in Hilsboro, Oregonbetween July 1, 2001 and September 30, 2001. Wedistributed educational materials to the primary carephysicians 2 months before screening patients. Over a 3month period, 3431 consecutive patients who visitedTuality Health Care primary care clinics were screenedusing a 2-item version of the Prime MDdepression-screening questionnaire. The primary carephysicians conducted further assessment for certainpatients to determine if any screened patient wasdepressed. We included all adult patients who visitedTuality Health Care primary care clinics between July 1,2001 and September 30, 2001 in the study. We excludedpatients attending the clinic for an emergency andchildren below 15 years of age.Results: Out of 3431 subjects initially screened, weincluded 3290 subjects (96%) in the analysis. Of these,360 subjects (10.9%) were already being treated fordepression. The median age of the population was 48.5,63.6% were females, and 36.4% were males. Physicianswere more likely to conduct further assessment fordepression when the screening result was positive (oddsratio [OR] = 119.13, 95% confidence interval [CI]:81.017-175.17). They were also more likely to make anew diagnosis of depression when the screening resultwas positive (OR = 117.245, 95% CI: 51.67-266.02).Conclusion: The intervention is a useful depressionscreening effort in primary care. We should also considerimplementation in other primary care settings.