TY - JOUR
AU - A. M. Farley
AU - R. J. Gallop
AU - E. S. Brooks
AU - M. Gerdes
AU - M. L. Bush
AU - J. F. Young
A1 - 
AB - OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
AD - Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ.; Department of Mathematics, West Chester University, West Chester, PA.; Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA.; Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA.; Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA.; Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA.; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
BT - Journal of developmental and behavioral pediatrics : JDBP
C5 - General Literature
CP - 2
CY - United States
DO - 10.1097/DBP.0000000000000750
IS - 2
JF - Journal of developmental and behavioral pediatrics : JDBP
M1 - Journal Article
N2 - OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
PP - United States
PY - 2020
SN - 1536-7312; 0196-206X
SP - 85
EP - 94
EP - 
T1 - Identification and Management of Adolescent Depression in a Large Pediatric Care Network
T2 - Journal of developmental and behavioral pediatrics : JDBP
TI - Identification and Management of Adolescent Depression in a Large Pediatric Care Network
U1 - General Literature
U2 - 31651619
U3 - 10.1097/DBP.0000000000000750
VL - 41
VO - 1536-7312; 0196-206X
Y1 - 2020
Y2 - Feb/Mar
ER -