Graduation Semester and Year

2019

Language

English

Document Type

Thesis

Degree Name

Master of Science in Social Work

Department

Social Work

First Advisor

Diane B Mitschke

Abstract

Depression is a common and costly chronic medical illness seen in health care settings, including primary care. Disparity populations in community settings are at risk for depression, but less likely to seek treatment for symptoms. This paper explores the screening, diagnosis, treatment, and follow-up patterns of depression in nine community clinics throughout North Texas. A retrospective study design was used to analyze electronic health record data in 2017. A total of 11,803 patients visited nine community care clinics in 2017. PHQ-2 counts were collected to assess for screening rates, while PHQ-9 counts were collected to assess for follow-up rates in concordance with Measurement Based Care (MBC) guidelines. Treatment patterns were assessed by reviewing the number of behavioral health visits as well as antidepressant use six months (180 days) following the first record of a depression diagnosis in 2017. Overall, the results show that the utilization of the PHQ-2 as a depression screening tool was higher than expected (67%). Twenty-four percent of the total patients had a diagnosis of depression in 2017, however, a large percentage of patients with a depression diagnosis did not have a recorded treatment plan (52%). Hispanic patients are more likely to receive PHQ-2 screening and more likely to engage in antidepressant use as well as behavioral health visits when compared to non-Hispanic patients. Alternatively, Hispanic patients were less likely to receive a depression diagnosis. In conclusion, universal screening for depression in primary care settings for disparity populations is necessary, however, appropriate follow up of depression symptoms must be in place to have effective health outcomes. Future research is necessary to identify support for health systems in implementing recommended guidelines for depression management.

Keywords

Depression, Measurement-based care, Health disparities, PHQ, Hispanic

Disciplines

Social and Behavioral Sciences | Social Work

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Comments

Degree granted by The University of Texas at Arlington

Included in

Social Work Commons

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