Key result
A gateway scoring approach using the PHQ-2 to 9 was feasible in post-acute care, with 28% of patients screening positive on the PHQ-2 and an average completion time of 2.3 minutes.
Why the study?
Existing instruments like the PHQ-2 and PHQ-9 have trade-offs between measurement depth and respondent/assessor burden in post-acute care settings.
Is a gateway scoring approach (PHQ-2 to 9) feasible for the standardized assessment of depression symptoms in post-acute care patients?
Cross-Sectional (n=3,010)
Yes
Is a gateway scoring approach (PHQ-2 to 9) feasible for the standardized assessment of depression symptoms in post-acute care patients?
A gateway scoring approach using the PHQ-2 to 9 is feasible for standardized assessment of depression symptoms in post-acute care patients, revealing a high prevalence of depression in this population.
Supports PHQ gateway screening feasibility in post-acute care; leaves open impact on outcomes and implementation.
BACKGROUND: Depression symptoms have impacts on quality of life, rehabilitation and treatment adherence, and resource utilization among patients in post-acute care (PAC) settings. The PHQ-2 and PHQ-9 are instruments for the assessment of depression, previously used in PAC settings, that have tradeoffs in terms of measurement depth versus respondent/assessor burden. Therefore, the present study tested a gateway version of the protocol (PHQ-2 to 9). METHODS: In 143 PAC settings in 14 U.S. markets across 10 states from November 2017 to August 2018, facility and research nurses administered the PHQ-2 to communicative patients (n = 3010). Nurses administered the full PHQ-9 if the patient screened positive for either of the two cardinal symptoms assessed by the PHQ-2 (depressed mood and anhedonia). We assessed the prevalence and frequency of depression symptoms using the PHQ-2 to 9, associations between depression screening results and patient characteristics and clinical conditions, and feasibility indicators. RESULTS: More than 1 in 4 patients (28%) screened positive on the PHQ-2. Only 6% of those completing the full PHQ-9 had a score indicating "minimal" severity. The average score (M = 11.9) met the threshold for moderate depression. Positive PHQ-2 screening was associated with age, female gender, disposition at discharge, septicemia/severe sepsis, and dependence for ADLs of toileting and lying to sitting mobility. Age was also associated with full PHQ-9 scores; patients ages 45-64 had the highest mean score. Length of stay was not associated with PHQ-2 screening results or full PHQ-2 to 9 scores. Missing data were minimal (<2.4%). The average time to complete was 2.3 min. Interrater reliability and percent agreement were excellent. CONCLUSIONS: These findings suggest the feasibility of a gateway scoring approach to standardized assessment of depression symptoms among PAC patients, and that depression symptoms are relatively common among this inpatient population.
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Siconolfi et al. (2022) conducted a cross-sectional in Depression symptoms in post-acute care (n=3,010). Gateway protocol (PHQ-2 to 9) was evaluated on Prevalence of positive depression screening. A gateway scoring approach using the PHQ-2 to 9 was feasible in post-acute care, with 28% of patients screening positive on the PHQ-2 and an average completion time of 2.3 minutes.
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