Measurement-based treatment is increasingly used for common behavioral health conditions, like depression. The screeners help identify people who may not otherwise be recognized as needing care. They also help to find out whether the symptoms are improving, and which specific symptoms are or are not improving. Treatment to target means that we adjust our treatment plan based on symptom measures until we reach 50% reduction (response to treatment.) This prevents treatment inertia as it helps the provider and the patient to know if the patient is having a full response, partial response, or no response. One of the screeners is PHQ9, which is free to use and well validated for depression. At our family practice clinic, evidence in support of measurement-based treatment to target and advantages of PHQ9 (including examples of the clinic’s patients who benefitted from use of PHQ9) were presented to providers. The goal was to increase their use of PHQ-9. To measure the outcome, a pre- and post-intervention anonymous survey was conducted. The response rate was 77.7% for pre-intervention survey and 100% for post-intervention survey (2 of the providers relocated before the post-intervention survey.) Before the intervention the providers reported use of PHQ9 to screen for depression was: Very often 28.57%, Often 14.29%, Sometimes 42.86%, Seldom 14.29%, I do not use PHQ-9 at all 0.00%. It improved to: Very often 40%, Often 20%, Sometimes 40%, Seldom 0.00%, I do not use PHQ-9 at all 0.00% after intervention. Their use of PHQ9 to monitor depression was: Very often 0.00%, Often 28.57%, Sometimes 28.57%, Seldom 42.86%, I do not use PHQ-9 at all 0.00% before the intervention. It improved to: Very often 0.00%, Often 40%, Sometimes 60%, Seldom 0.00%, I do not use PHQ-9 at all 0.00% after the intervention. In conclusion, awareness of the evidence on advantages of screeners for depression could increase primary care providers’ use of them in screening for and monitoring depression.
Tehrani, Poone Haghani. "Measurement-Based Treatment to Target for Depression: Use of PHQ-9 in Primary Care." (2019). https://digitalrepository.unm.edu/hsc_ed_day/64