Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care

Aalsma, Matthew C.; Zerr, Ashley M.; Etter, Dillon J.; Ouyang, Fangqian; Gilbert, Amy; Rc, Williams; Hall, James A.; Downs, Stephen M.

doi:10.1016/j.jadohealth.2017.08.023

Cited by 12 publications

(16 citation statements)

References 35 publications

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“…Based on patients' responses to these questions, a primary care provider worksheet is generated prioritizing the top six health needs of the patient with provider action prompts based on Bright Futures guidelines (Tanski, Garfunkel, Duncan, & Weitzman, 2010). A detailed description of the system has been described elsewhere (Aalsma et al, 2018;Anand, Biondich, Liu, Rosenman, & Downs, 2004;Anand, Carroll, Biondich, Dugan, & Downs, 2015;Carroll et al, 2013;Gilbert & Downs, 2015).…”

Section: Participants and Settingmentioning

confidence: 99%

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The Natural Course of Adolescent Depression Treatment in the Primary Care Setting

Stafford¹,

Garbuz²,

Etter³

et al. 2020

Journal of Pediatric Health Care

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Introduction: Little is known about how adolescents receive depression follow-up in primary care. The purpose of this study was to describe the rates of symptom assessment and depression treatment over time in a group of adolescents screening positive for moderate or severe depression in the primary care setting. Methods: Retrospective chart reviews were conducted to gather information related to symptom reassessments, antidepressant prescriptions, psychotherapy referrals, and treatment discontinuation. Descriptive statistics were calculated, and a qualitative content analysis was conducted to determine the reasons for treatment discontinuation. Results: Eighty records were reviewed (mean age = 15.3, 73% female, 59% Black). Treatment was initiated for 83% (n = 66) of patients, and 45% (n = 30) of patients discontinued treatment during the review period for a variety of reasons.

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Section: Participants and Settingmentioning

confidence: 99%

“…The research team created and tested an adolescent depression module (Aalsma et al, 2018). Adolescents aged 12−20 years were screened explicitly for depression on the PSF using the Patient Health Questionnaire-2 (PHQ-2; Richardson et al, 2010b) with a reflex Patient Health Questionnaire-9 (PHQ-9; Richardson et al, 2010a).…”

Section: Participants and Settingmentioning

confidence: 99%

The Natural Course of Adolescent Depression Treatment in the Primary Care Setting

Stafford¹,

Garbuz²,

Etter³

et al. 2020

Journal of Pediatric Health Care

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“…However, when health care policy (e.g., USTSPF recommendation for screening youth) starts to look too much like an advertisement for cherished beliefs, we cannot claim to be engaging in evidence-based practice [see, e.g., (36)]. Moreover, routine depression screening may have the unintended effect of overtreatment with antidepressants and could deflect limited healthcare resources away from those who need it most (2,18,31,(37)(38)(39). Research demonstrates that a stepped approach is best: treating mild-moderate depression with an antidepressant has been found to be no better than watchful waiting (40,41).…”

Section: Depression Screening In Adolescents: Is There Evidence Of Bementioning

confidence: 99%

Drivers of and Solutions for the Overuse of Antidepressant Medication in Pediatric Populations

et al. 2020

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Children in the United States and internationally are increasingly being diagnosed with depression and related psychiatric conditions and a recent study found that antidepressant (ADM) use in children and adolescents rose substantially in youth cohorts in five Western countries from 2005 to 2012. However, there has been ongoing controversy over the effectiveness and safety of ADM use in children, including concerns about ADM increasing suicidality and self-harm. In addition to the increase in the diagnosis of depression, commercially driven off-label prescriptions have been cited as a significant reason for high rates of pediatric ADM prescribing. In this commentary, we discuss two drivers of the overuse of ADM, both of which are products of an increasingly medicalized approach to mental health: 1) the demand for mental health and depression screening in youth, despite the lack of evidence to support it, and 2) the renewed momentum of the Global Mental Health Movement and concomitant calls to "scale up" the diagnosis and treatment of mental illness. Using the lens of institutional corruption, we identify the ways in which both guild and financial conflicts of interest create obstacles to rational prescribing practices in pediatric populations and offer suggestions for reform.

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“…Last, CHICA has a library of patient and physician handouts it can print as needed based on issues it has identified. CHICA covers a wide range of topics in primary pediatric care, from lead screening 20 and asthma 19 to adolescent depression 29 and type 2 diabetes. 23 The AAP ASD guidance was encoded in the CHICA ASD module by creating rules that directed both surveillance and screening.…”

Section: Interventionmentioning

confidence: 99%

Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics

Downs

Bauer²,

Saha

et al. 2019

JAMA Netw Open

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IMPORTANCE Universal early screening for autism spectrum disorder (ASD) is recommended but not routinely performed. OBJECTIVE To determine whether computer-automated screening and clinical decision support can improve ASD screening rates in pediatric primary care practices. DESIGN, SETTING, AND PARTICIPANTS This cluster randomized clinical trial, conducted between November 16, 2010, and November 21, 2012, compared ASD screening rates among a random sample of 274 children aged 18 to 24 months in urban pediatric clinics of an inner-city county hospital system with or without an ASD screening module built into an existing decision support software system.

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Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care

Abstract: When a computer-based decision support system algorithm focused on adolescent depression was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.

Cited by 12 publications

References 35 publications

The Natural Course of Adolescent Depression Treatment in the Primary Care Setting

The Natural Course of Adolescent Depression Treatment in the Primary Care Setting

Drivers of and Solutions for the Overuse of Antidepressant Medication in Pediatric Populations

Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics

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