Utilization of the Patient Health Questionnaire to monitor depression in a primary care setting

Purpose: Depression is a very common disease, which affected up to 10% of the U.S. population.  The Patient Health Questionnaire (PHQ-9) is an effective tool for screening, diagnosing and monitoring depression.  The primary objective for this study was to determine how often practitioners in an outpatient family practice clinic use the PHQ-9 to monitor depression. 

Methods: A retrospective chart review was performed at the Wyoming Family Practice center, where the PHQ-9 is easily accessible and pre-loaded into the medical record.  Inclusion criteria were patients 18 years of age or older, who had a diagnosis of depression, were prescribed an antidepressant medication and had seen a clinic provider at least 2 times in the previous 18 months.  Exclusion criteria were patients who did not meet the inclusion criteria and patients who had a psychiatric comorbidity that was monitored by other applicable scales. 

Results: A total of 106 patient medical records were evaluated.  Data was collected on several parameters including patient gender, age, prescribed antidepressant medication and PHQ-9 assessments.  A total of 27 patients (25%) had at least 1 PHQ-9 documented in the 18 month period evaluated.  A PHQ-9 assessment was more frequently performed in patients between 21-30 years of age, female patients and those prescribed either duloxetine or venlafaxine.

Conclusion: Multiple studies have proven the PHQ-9 assessment is an effective tool for monitoring depression.  Our study showed physicians in this setting are not effectively using the PHQ-9 to monitor depression and patient response to antidepressant medications.  Focus groups will be formed to discuss barriers and resolutions to increased PHQ-9 utilization.