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In 2017, an estimated 17.3 million adults (7.1%) in the United States had at least one major depressive episode. Although there are known, effective treatments for depression, fewer than half of those affected receive such treatments. LVHN implemented an Ambulatory Clinical Depression Pathway at three pilot sites to improve depression screening, symptom management, remission documentation, and patient quality of life. The pathway utilized the PHQ-9 metric for evaluating and tracking severity of depression while providing guidelines for short- and long-term follow up, patient education, and medical management. Five hundred twenty-five individuals were screened during the 6-month pilot study; 38% were diagnosed with depression (PHQ Score =5). Of those, 82% were prescribed antidepressant medications and 60% received education. Over-the-phone follow up for moderately-severe to severe patients occurred in 28% of encounters, while in-office follow up was completed within 6 months for 32% of depressed patients. Seventy three percent of patients who followed up showed improvement in depression with a 15% rate of complete remission. One site’s decreased adherence (58% screened, 24% in-office follow up) resulted in less response in more severe depression.


Department of Family Medicine, Department of Family Medicine Faculty

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