Table 2.
Current Practice of PMAD Management.
| Variable | N | % |
|---|---|---|
| To what extent do you manage PMAD in your current clinical practice? | ||
| Not at all | 9 | 7.6 |
| A little | 47 | 39.8 |
| A moderate amount | 31 | 26.3 |
| A lot | 12 | 10.2 |
| I provide PMAD management to every patient with elevated depression and anxiety | 19 | 16.1 |
| Out of 10 patients you see with psychiatric/psychological concerns, for how many would you expect to provide PMAD management? | ||
| 1-3 | 55 | 47.8 |
| 4-6 | 23 | 20.0 |
| 7-9 | 25 | 21.7 |
| All 10 | 12 | 10.4 |
| Do you use any patient standardized self-report measures to assess for depression, anxiety, or other psychiatric/psychological symptoms? (Mark all that apply) | ||
| We do not screen for psychiatric/psychological symptoms | 3 | 2.5 |
| Edinburgh Postnatal Depression Scale (EPDS) | 49 | 41.5 |
| Patient Health Questionnaire – 9 items (PHQ-9) | 89 | 75.4 |
| Patient Health Questionnaire – 2 items (PHQ-2) | 13 | 11.0 |
| Mood Disorder Questionnaire (MDQ) | 19 | 16.1 |
| Generalized Anxiety Disorder – 7 items (GAD-7) | 75 | 63.6 |
| PTSD Checklist – Civilian Version (PCLC) | 2 | 1.7 |
| Alcohol Use Disorders Identification Test (AUDIT) | 31 | 26.3 |
| Drug Abuse Screening Test (DAST) | 3 | 2.5 |
| Other | 12 | 10.2 |
| How often do you administer the standardized self-report measures? (Mark all that apply) | ||
| When patient expresses PMAD symptoms | 48 | 40.7 |
| Initial visit only | 15 | 12.7 |
| Once each trimester | 11 | 9.3 |
| Once between initial visit and postpartum | 18 | 15.3 |
| Postpartum only | 28 | 23.7 |
| All prenatal visits | 6 | 5.1 |
| All prenatal and postnatal visits | 7 | 5.9 |
| After pregnancy loss | 17 | 14.4 |
| Intend to screen, but it is not always completed | 9 | 7.6 |
| Other | 31 | 26.3 |
| What are the barriers to use standardized self-report measures to assess for psychiatric/psychological symptoms? (Mark all that apply) | ||
| No time | 27 | 22.9 |
| No reimbursement | 3 | 2.5 |
| Low number of patients with psychiatric/psychological concerns | 6 | 5.1 |
| No resources to refer patients with psychiatric/psychological concerns | 20 | 16.9 |
| Do not feel comfortable to assess | 3 | 2.5 |
| Do not have adequate training | 10 | 8.5 |
| Patients do not like us to ask questions related to psychiatric/psychological concerns | 5 | 4.2 |
| Our practice do not have adequate resources to implement self-report measures (eg, lack of staffing, lack of electronic health records) | 9 | 7.6 |
| Other | 29 | 24.6 |
| What steps do you take when patients reported elevated psychiatric/psychological symptoms? (Mark all that apply) | ||
| I provide further evaluation | 95 | 80.5 |
| I provide further treatment | 78 | 66.1 |
| Refer to my own services | 24 | 20.3 |
| Refer to mental health clinic/agency | 79 | 66.9 |
| Refer to individual mental health provider | 66 | 55.9 |
| Refer to hospital social worker | 36 | 30.5 |
| Refer to other type of provider | 33 | 28.0 |
| I do not know what further services are available | 0 | 0 |
| Other steps taken | 9 | 7.6 |