Routine depression screening which may capture underdiagnosed patient populations

Implementation Leads to Better Symptom Recognition in Older Adults, Minorities, Men, Non-English Speakers, UCSF-Led Study Shows Screening for depression at the primary care level could dramatically increase the likelihood of treatment for those who are traditionally undertreated — racial and ethnic minority individuals, older adults, those with limited English proficiency and men — according to a new study led by UC San Francisco.

The researchers tracked electronic health data of 52,944 adult patients seen at six UCSF primary care facilities over a two-year period. After a routine screening policy was implemented, depression screening rates more than doubled — from 40.5% in 2017 to 88.8% in 2019, the researchers reported in their study, published in JAMA Network Open.

In 2018, they found that for every 100 patients ages 18 to 30 screened for depression, 75 patients ages 75 and older were likely to be screened for depression. For every 100 English-speaking white patients screened for depression, there were 59 Chinese-language patients and 55 other non-English language patients likely to be screened for depression.

By 2019, statistically significant disparities virtually disappeared for older patients, Black/African Americans, other English-speaking patients and patients with language barriers. However, screening for men remained relatively low: for every 100 women screened for depression, 87 men were likely to be screened for depression, compared to 82 men before the policy was implemented.

"Our study shows that a systems-based approach can increase depression screening and address screening disparities," said senior author Leah S. Karliner, MD, professor in the UCSF Division of General Internal Medicine.

"Depression screening is necessary, but not sufficient, to decrease care disparities. Screening may help with poor physician recognition of depressive symptoms, but it must be followed by clinical action," said first author Maria E. Garcia.

Ref: Maria E. Garcia.et. al,JAMA Network Open