Derail Depression: Assessing the Effectiveness of a Continuing Education Quality Improvement Program

Abstract: Nearly 15 million adults in the US have experienced one or more major depressive disorder (MDD) events in the past year; primary care clinicians are the first line for initial diagnosis and management. To encourage increased MDD screening and improve measurement-based patient care, a quality improvement (QI) program was established at 42 practices at Lancaster General Health (LGH) in Pennsylvania and the University of Kentucky (UK). This program included adding the PHQ-9 to the EHR, creating an order set to screen all adults annually, and providing patient-directed education including a PHQ-9 smartphone app that sends data to the EHR. Online clinician education covered topics such as the importance of measurement-based depression screening, managing MDD pharmacologically and nonpharmacologically, and employing a collaborative care model. Over 5,000 clinician learners from LGH, UK, and outside of these systems engaged in the educational activity. EHR data from LGH and UK was analyzed to determine the overall effect of the initiative. In the clinics, the average rate of depression screening increased from 27% to 48% at LGH and from 3% to 19% at UK. The average rate of referral to counseling increased by 217% from baseline at LGH. At UK, PHQ-9 scores decreased by 38% on follow-up. Based on these results, the combined online educational initiatives with in-practice QI had a significant effect on improving screening in primary care, increasing referrals to counseling, and reducing MDD severity based on PHQ-9 scores. Continued education is needed to expand this initiative to other areas and practices.Short Description: From the start of the COVID-19 pandemic, MDD) rates are increasing, creating challenges on primary care physicians (PCPs) including screening, low medication adherence, and suboptimal management. A quality improvement and educational initiative was developed to encourage higher rates of MDD screening and improved management for PCPs. Outcomes from this program reflect increased screening, increased referral for counseling, and improved patient mental health.Name of Sponsoring Organization(s): DKBmed, medical education provider Postgraduate Institute for Medicine, accredited provider Otsuka America Pharmaceuticals, Inc, financial supporter Takeda Pharmaceuticals U.S.A, financial supporter Lundbeck, financial supporter