Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics
Objective To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.Design Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-...
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| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e088973.full |
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| author | Tess Battiola Tanner Ellison Danica Dummer Rachel Weir Katie Kaput Deepika Reddy |
| author_facet | Tess Battiola Tanner Ellison Danica Dummer Rachel Weir Katie Kaput Deepika Reddy |
| author_sort | Tess Battiola |
| collection | DOAJ |
| description | Objective To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.Design Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.Setting University of Utah and University of Utah Health-affiliated primary care and specialty clinics.Participants Adults who screened positive for depressive symptoms (score≥10) on the Patient Health Questionnaire (PHQ-9) at an ambulatory visit between 1 January 2021 and 31 January 2022. A total of 17 651 patients were included in the study.Outcome measures Follow-up for positive depression screens was defined as a new antidepressant prescription or completed mental health visit. Variables associated with follow-up included patient demographic data, anthropometric measures, geographical classification, primary language, comorbidities and socioeconomic factors as well as provider demographics, level of training and clinic type.Results 5396 patients (30.6%) did not receive follow-up care for a positive PHQ-9 screen. Factors associated with lower rates of follow-up included male patients (gender; p=0.013), older patients (age group; p=0.016), non-White patients (ethnicity; p<0.0001), non-English (primary language; p<0.0001), lack of insurance (p<0.0001), older providers (p=0.027), male providers (p=0.0037) and attending-level providers (p<0.0001).Conclusions Significant discrepancies in follow-up for positive depression screens in the ambulatory setting exist, particularly among racial/ethnic minority groups and patients who are non-native English speakers. Older providers and attending-level providers were less likely to facilitate follow-up for positive depression screens in their clinics. |
| format | Article |
| id | doaj-art-0d8b5c18214347be8920e19a3bb8fae7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-0d8b5c18214347be8920e19a3bb8fae72025-01-15T02:00:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-088973Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinicsTess Battiola0Tanner Ellison1Danica Dummer2Rachel Weir3Katie Kaput4Deepika Reddy5Endocrinology, University of Utah Health, Salt Lake City, Utah, USAMedical Group Analytics, University of Utah Health, Salt Lake City, Utah, USAMedical Group Analytics, University of Utah Health, Salt Lake City, Utah, USAPsychiatry, Huntsman Mental Health Institute, University of Utah Health, Salt Lake City, Utah, USAEndocrinology, University of Utah Health, Salt Lake City, Utah, USAEndocrinology, University of Utah Health, Salt Lake City, Utah, USAObjective To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.Design Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.Setting University of Utah and University of Utah Health-affiliated primary care and specialty clinics.Participants Adults who screened positive for depressive symptoms (score≥10) on the Patient Health Questionnaire (PHQ-9) at an ambulatory visit between 1 January 2021 and 31 January 2022. A total of 17 651 patients were included in the study.Outcome measures Follow-up for positive depression screens was defined as a new antidepressant prescription or completed mental health visit. Variables associated with follow-up included patient demographic data, anthropometric measures, geographical classification, primary language, comorbidities and socioeconomic factors as well as provider demographics, level of training and clinic type.Results 5396 patients (30.6%) did not receive follow-up care for a positive PHQ-9 screen. Factors associated with lower rates of follow-up included male patients (gender; p=0.013), older patients (age group; p=0.016), non-White patients (ethnicity; p<0.0001), non-English (primary language; p<0.0001), lack of insurance (p<0.0001), older providers (p=0.027), male providers (p=0.0037) and attending-level providers (p<0.0001).Conclusions Significant discrepancies in follow-up for positive depression screens in the ambulatory setting exist, particularly among racial/ethnic minority groups and patients who are non-native English speakers. Older providers and attending-level providers were less likely to facilitate follow-up for positive depression screens in their clinics.https://bmjopen.bmj.com/content/15/1/e088973.full |
| spellingShingle | Tess Battiola Tanner Ellison Danica Dummer Rachel Weir Katie Kaput Deepika Reddy Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics BMJ Open |
| title | Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics |
| title_full | Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics |
| title_fullStr | Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics |
| title_full_unstemmed | Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics |
| title_short | Patient and provider factors associated with follow-up for positive depression screens in adults: a retrospective review of University of Utah primary and specialty care clinics |
| title_sort | patient and provider factors associated with follow up for positive depression screens in adults a retrospective review of university of utah primary and specialty care clinics |
| url | https://bmjopen.bmj.com/content/15/1/e088973.full |
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