Protocol Implementation for Depression and Anxiety Screening in an Outpatient Epilepsy Clinic Using Electronic Capture Devices
Abstract number :
3.271
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2022
Submission ID :
2204817
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Patrick Rooney, MD – University of Rochester Medical Center; Alyssa Cuchanski, DO – Neurology – Geisinger; Thomas Wychowski, MD – Neurology – University of Rochester Medical Center
Rationale: Mood disorders disproportionately affect persons with epilepsy (PWE), with approximately 20% of patients concurrently suffering from anxiety or depression [1]. Screening for depression and anxiety is recommended as part of routine outpatient care for patients with epilepsy [2]. The purpose of this study was to assess the impact of the implementation of an electronic capture screening tool (Patient-Reported Outcomes Measurement Information System, PROMIS®) on the management of mood disorders in our outpatient clinic._x000D_
Methods: A standardized protocol for mood screening using PROMIS Depression and PROMIS Anxiety was implemented in January 2021. To assess impact on clinical care, a retrospective cohort study was used to compare outcomes between the pre- and post-intervention group through review of encounter documentation and orders. Due to potential confounding related to onset of the COVID-19 pandemic, a second historical cohort (pre-invention, post-COVID) was included. The primary measures of interest were providers’ documentation of depression/anxiety symptoms, and interventions made for symptoms of depression/anxiety._x000D_
Results: A total of 171 encounters were reviewed for the pre-intervention historical cohort, with an additional 77 encounters reviewed after the start of the COVID-19 pandemic. A total of 55 patient encounters were reviewed following the post-intervention cohort. Provider documentation of a query of depressive symptoms occurred in 14% to 17% of encounters in the historical cohorts compared to 66% of encounters in the post-intervention cohort (p < 0.05). Documented screening for suicide occurred in 4% of cases in the historical cohorts compared to 22% in the post-intervention cohort (p < 0.05). Provider documentation of a query of anxiety symptoms did not differ significantly between the historical cohorts (17%-20%) and post-intervention cohort (15%) (p =0.76). Interventions for depressive symptoms occurred in 22% to 46% of encounters in the historical cohorts compared to 50% in the post-intervention cohort (p = 0.068). Interventions for anxiety symptoms occurred in 20% to 31% of patients in the historical cohorts compared to 65% in the post-intervention cohort (p < 0.05)._x000D_
Cormorbidity (Somatic and Psychiatric)