TABLE 4.
Associations between visit characteristics and Patient Health Questionnaire-9 (PHQ-9) administration for both versions of the clinical decision support (CDS) tool
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CDS Version 1
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CDS Version 2
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PHQ-9 Not Administered, n (%)
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PHQ-9 Administered, n (%)
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P
Value
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PHQ-9 Not Administered, n (%)
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PHQ-9 Administered, n (%)
|
P
Value
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|
| Type of practice | ||||||
| Family medicine | 238 (56) | 55 (71) | .037a | 295 (65) | 36 (73) | .33a |
| Internal medicine | 180 (42) | 21 (27) | 146 (32) | 13 (27) | ||
| Geriatrics | 9 (2) | 1 (1) | 12 (3) | 0 (0) | ||
| Type of encounter | ||||||
| Acute | 25 (6) | 2 (3) | .114a | 27 (6) | 2 (4) | .582a |
| Preventative | 301 (70) | 63 (82) | 419 (92) | 47 (96) | ||
| New to establish care | 101 (24) | 12 (16) | 7 (2) | 0 (0) | ||
| Clinician type | ||||||
| Attending | 311 (73) | 57 (74) | .62a | 404 (89) | 39 (80) | .048a |
| Advanced practice provider | 60 (14) | 8 (10) | 49 (11) | 10 (20) | ||
| Resident | 56 (13) | 12 (16) | 0 (0) | 0 (0) | ||
| Encounter clinician is patient's PCP | 200 (47) | 41 (53) | .300 | 266 (59) | 29 (59) | .95 |
| Something urgent addressed at visit | 18 (4) | 5 (6) | .897 | 8 (2) | 0 (0) | .348 |
| Referral to psychiatrist placed at visit | 2 (0) | 5 (6) | <.001 | 4 (1) | 0 (0) | .509 |
| Referral to psychologist placed at visit | 6 (1) | 1 (1) | .941 | 3 (1) | 0 (0) | .568 |
| Change in medications at visit | 16 (4) | 17 (22) | <.001 | 10 (2) | 5 (10) | .002 |
| Depression/dysthymia billed at visit | 0 (0) | 2 (3) | .001 | 2 (0) | 0 (0) | .641 |
| Psychiatric indication billed at visit | 4 (1) | 3 (4) | .041 | 0 (0) | 0 (0) | … |
| Patient has dysthymia or chronic depression | 267 (63) | 57 (74) | .053 | 346 (76) | 45 (92) | .013 |
| Patient has bipolar disorder | 19 (4) | 5 (6) | .438 | 33 (7) | 4 (8) | .823 |
| Patient has personality disorder | 8 (2) | 1 (1) | .7259 | 13 (3) | 2 (4) | .6360 |
| No. of antidepressants prescribed, median (IQR) | 1 (0, 1) | 1 (0, 1) | .0134 | 1 (0, 1) | 1 (1, 2) | .0027 |
| No. of psychotropics prescribed, median (IQR) | 0 (0, 0) | 0 (0, 0) | .9144 | 0 (0, 0) | 0 (0, 0) | .8405 |
PCP = primary care provider.
a
A chi-square test was used to evaluate associations between visit characteristics and PHQ-9 administration. This statistical test evaluates whether the distribution of PHQ-9 administration across all characteristics (eg, across all 3 types of practice) differs significantly between those that were administered the PHQ-9 and those that were not.