TABLE 4.
Outcome Measures Pre- and Post-QI Intervention to Improve Follow-Up Care for Adolescents Newly Diagnosed With Depression
| Factor | Preinterventiona (N = 199) | Postinterventiona (N = 217) | P |
|---|---|---|---|
| Primary outcome | |||
| Follow-up care, n (%) | |||
| At diagnosis, follow-up care (either call or visit) within 6 wk | 70/177b (40) | 160/197b (81) | <.001 |
| Once stable, follow-up care within 3-mo | 32/108c (30) | 75/126c (60) | <.001 |
| Secondary outcomes | |||
| PHQ-A use, n (%) | |||
| Proportion with PHQ-A used at diagnostic visit | 118/199 (59) | 186/217 (86) | <.001 |
| Proportion with PHQ-A used at least 1 follow-up visit | 38/113d (34) | 148/194d (76) | <.001 |
| Proportion with PHQ-A used at every follow-up visit | 20/113d (18) | 95/194d (49) | <.001 |
| Patient improvement | |||
| Proportion with remission at 6-mo | 7/107e (7) | 41/193e(21) | <.001 |
| Provider confidencef: | (N = 49) | (N = 47) | |
| Make a diagnosis of depression, n (%) | 18 (37) | 36 (77) | <.001 |
| Assess depression severity, n (%) | 8 (16) | 28 (60) | <.001 |
| Assess for suicidal intent, n (%) | 16 (33) | 25 (53) | .06 |
| Assess treatment response, n (%) | 13 (27) | 25 (53) | .01 |
| Prescribe SSRIs for initial treatment, n (%) | 28 (57) | 40 (85) | .003 |
| Prescribe second drug if partial or no benefit with first drug, n (%) | 7 (14) | 22 (47) | <.001 |
| Ability to educate patients and families, n (%) | 10 (20) | 29 (62) | <.001 |
PHQ-A, Patient Health Questionnaire-9 modified for teens;26 QI, quality improvement; SSRI, selective serotonin reuptake inhibitor.
Denominator varies as number of patients eligible for metric varies, depending on date of diagnosis.
Excluded from denominator if diagnosed in last 6 wk of the measurement period.
Excluded from denominator if diagnosed in last 3 mo of the measurement period.
Excluded from the denominator if no follow-up visit during the measurement period.
The percentage of patients who achieved remission (PHQ-A <5) at 6 mo after the initial elevated PHQ-A score. Excluded from the denominator if no follow-up visit within 6 mo.
Percent of providers scoring confidence >6 out of 7 (1, not confident to 7, highly confident).