URMC Universal Depression Screening Initiative: Patient Reported Outcome Assessments to Promote a Person-Centered Biopsychosocial Population Health Management Strategy.
URMC Universal Depression Screening Initiative: Patient Reported Outcome Assessments to Promote a Person-Centered Biopsychosocial Population Health Management Strategy.
复制标题
DOI：
10.3389/fpsyt.2021.796499
复制
发表时间：
2021
影响因子：
4.7
通讯作者：
Baumhauer JF
中科院分区：
文献类型：
--
作者：
Van Orden KA;Lutz J;Conner KR;Silva C;Hasselberg MJ;Fear K;Leadley AW;Wittink MN;Baumhauer JF
背景资料：患者报告的结果（PRO）可以通过测量对患者重要的结果（包括功能和福祉）来促进以人为本的生物心理社会卫生保健。数据支持PRO给药作为常规临床护理的一部分的可行性和可接受性，但对其对人群健康的影响知之甚少，包括检测未满足的医疗保健需求。我们的目标是研究在一个大型卫生系统中，来自通用抑郁症筛查的不同社会人口学群体和临床环境中临床显著抑郁症发生率的差异，估计通过筛查检测到的未经治疗的抑郁症患者的数量，并研究生物心理社会PRO-身体、心理和社会健康之间的关联。研究方法：我们分析了超过20万名成年患者的数据，这些患者完成了抑郁筛查-PROMIS（患者报告结局测量信息系统）或PHQ-2/9-作为常规门诊护理的一部分。结果如下：抑郁筛查在14.2%的样本中呈阳性，年轻人与老年人、女性与男性、非白色人与白色人、西班牙裔与非西班牙裔之间的阳性筛查更多。这些相同的社会人口统计学指标，以及在初级保健（与专科护理）中完成筛查，也与病历中检测到抑郁症的可能性更大有关。讨论内容：在整个大型卫生系统中对抑郁症状进行普遍筛查似乎是可以接受的，并且有可能在行为健康之外的不同患者人群中发现抑郁症。应探索扩大PRO的提供范围，以包括身体和社会健康以及抑郁症，以制定一个临床相关的模型，在整个卫生系统中以综合方式解决患者的生物心理社会需求。
Background: Patient-reported outcomes (PROs) can promote person-centered biopsychosocial health care by measuring outcomes that matter to patients, including functioning and well-being. Data support feasibility and acceptability of PRO administration as part of routine clinical care, but less is known about its effects on population health, including detection of unmet healthcare needs. Our objectives were to examine differences in rates of clinically significant depression across sociodemographic groups and clinical settings from universal depression screens in a large health system, estimate the number of patients with untreated depression detected by screenings, and examine associations between biopsychosocial PROs—physical, psychological, and social health. Methods: We analyzed data from over 200,000 adult patients who completed depression screens—either PROMIS (Patient Reported Outcomes Measurement Information System) or PHQ-2/9—as part of routine outpatient care. Results: Depression screens were positive in 14.2% of the sample, with more positive screens among younger vs. older adults, women vs. men, non-White vs. White, and Hispanics vs. non-Hispanics. These same sociodemographic indicators, as well as completing screening in primary care (vs. specialty care) were also associated with greater likelihood of detected depression in the medical record. Discussion: Universal screening for depression symptoms throughout a large health system appears acceptable and has the potential to detect depression in diverse patient populations outside of behavioral health. Expanded delivery of PROs to include physical and social health as well as depression should be explored to develop a clinically-relevant model for addressing patients' biopsychosocial needs in an integrated fashion across the health system.
登录
查看更多内容
影响因子：
17.7
作者：
Oquendo, MA;Ellis, SP;Mann, JJ
通讯作者：
Mann, JJ
影响因子：
3.7
作者：
Ettman CK;Cohen GH;Abdalla SM;Galea S
通讯作者：
Galea S
影响因子：
12.7
作者：
Riolo, SA;Nguyen, TA;King, CA
通讯作者：
King, CA
影响因子：
1.8
作者：
Papuga, M. O.;Dasilva, C.;Baumhauer, J. F.
通讯作者：
Baumhauer, J. F.
影响因子：
4.7
作者：
Katz, Patricia;Yazdany, Jinoos;Dall'Era, Maria
通讯作者：
Dall'Era, Maria