The purpose of this study was to determine the practices of primary care providers in relation to screening and treating geriatric depression. According to the Geriatric Mental Health Foundation (GMHF), depression and suicide are significant public health issues for older adults, noting that depression is one of the most common mental disorders experienced by elders. Research indicates the issue of geriatric depression is poorly approached by providers and patients do not receive appropriate care. Depression cannot be measured with lab or diagnostic tests; the only way to assess depression is to screen patients by asking questions. When screening for depression, understanding that follow-up with treatment is equally as important as the diagnosis is imperative. Currently, the United States Preventative Services Task Force (USPSTF) has very narrow guidelines that recommend screening for depression in the general adult population, with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. Permission to conduct the study was initially obtained from the Institutional Review Board at Mississippi University for Women. Providers were asked to complete a multi-question survey created by the researchers, indicating current depression screening practices, which was available on both Survey Monkey and on paper. Upon obtaining 100 surveys, 99 were included in data analysis and 97% of respondents identified as a nurse practitioner. Upon analysis of the statistical data, the research questions were reviewed and are as follows: 1) Do primary care providers perform depression screening on geriatric patients? 2) What barriers exist to performing depression screening on geriatric patients? 3) If geriatric patients are identified as at risk for depression, what interventions are being utilized by primary care providers to address this issue?
The data indicated 40% of the surveyed providers reported screening every geriatric patient for depression, but the vast majority do not automatically screen geriatric patients for depression. Data also indicated barriers to screening every geriatric patient for depression included time constraints, patient declination, the screening being deemed unnecessary, or lack of reimbursement. Approximately one-third of providers admitted to not having time to screen patients for depression. Fifteen percent of providers identified the patient declining being screened as a barrier. Twelve percent of providers felt the screening was unnecessary, and researchers were unsure of the criteria utilized by the provider to deem depression screening unnecessary. The researchers determined in the third question what interventions were implemented by providers upon the patients having a score indicative of depression. The options available were medication(s), psychiatry, therapy, or multiple combinations of the three options. The research indicated no statistically significant pattern of treatment is being followed by providers, although medication alone or with other options was used by a majority of respondents. The researchers determined primary care practitioners are not adequately screening and treating geriatric depression.
Master of Science in Nursing (MSN)
Dr. Sally Pearson
Flora, Ashleigh; Moon, Devi; Prisock, Tiffine; Reeves, Shelby; and Romero, Rachel, "An Assessment of the Utilization of Geriatric Depression Screenings in Primary Care Providers" (2020). MSN Research Projects. 265.