URMC Universal Depression Screening Initiative

Patient Reported Outcome Assessments to Promote a Person-Centered Biopsychosocial Population Health Management Strategy

Bibliographic Data

ID15517469
AuthorsKimberly A Van Orden (0000-0001-9439-401X, University of Rochester Medicine, corresponding author), Julie Lutz (0000-0002-0937-3028, University of Rochester Medicine), Kenneth R Conner (0000-0003-1083-5872, University of Rochester Medicine), Caroline Silva (0000-0002-7477-1495, University of Rochester Medicine), Michael J Hasselberg (0000-0001-8646-5068, University of Rochester Medicine), Kathleen Fear (0000-0003-4608-6949, University of Rochester Medicine), Allison W Leadley (University of Rochester Medicine), Marsha N Wittink, Marsha Wittink (0000-0002-3037-9723, University of Rochester Medicine), Judith F Baumhauer (0000-0003-2142-7778, University of Rochester Medicine)
Year2022
Volume12
Pages796499-796499
Publication date2022-01-11
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2021.796499
PMID35087432
OpenAlexW4206291105
LanguageEN
Citations received1
References cited32

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

Biopsychosocial model · Depression (economics · Environmental health · Outcome (game theory · Population · Psychiatry · Psychotherapist · Clinical Psychology · Family Caregiving in Mental Illness · Health Systems, Economic Evaluations, Quality of Life · Medicine · Mental Health Treatment and Access · Psychology

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