scholarly journals Impact of a clinical pharmacist–managed clinic in primary care mental health integration at a Veterans Affairs health system

2018 ◽  
Vol 8 (3) ◽  
pp. 105-109 ◽  
Author(s):  
Christina Herbert ◽  
Holly Winkler
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Antidepressant Medication ◽  
Medication Possession Ratio ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Primary Care Mental Health ◽  
Mental Health Integration ◽  
Patient Health ◽  
The Impact

Abstract Introduction: The demand for mental health (MH) services has increased as more veterans seek MH care. At the South Texas Veterans Health Care System, Primary Care Mental Health Integration (PCMHI) was developed to manage patients with uncomplicated MH conditions, including depression, anxiety, or posttraumatic stress disorder (PTSD), within an interdisciplinary primary care (PC) team that includes clinical pharmacy specialists (CPSs). Pharmacists have improved outcomes and access to care for many chronic medical conditions, but limited data demonstrate the impact of MH pharmacists within PC. Methods: This project evaluated the impact of a PCMHI CPS clinic on managing patients with recent antidepressant initiation and CPS clinic intake from September 2015 through December 2016, including follow-up through January 2017. Markers used to evaluate effectiveness of the service included the Patient Health Questionnaire-9 scores, antidepressant medication possession ratio, number of emergency department visits for MH-related concerns, patient engagement in concurrent psychotherapy, and referrals to specialty MH providers. Results: A total of 196 unique patients had intake with the PCMHI CPS in the time specified; 172 of these patients were included in analyses. There were 155 patients maintained in PC. Average Patient Health Questionnaire-9 scores decreased from 14.5 to 8.5, with 63 patients (46%) achieving response and 42 patients (31%) achieving remission. The average antidepressant medication possession ratio was 0.93 for all included patients. Discussion: A PCMHI CPS successfully manages and maintains patients with uncomplicated MH conditions in PC through evidence-based pharmacotherapy, as evidenced by symptom improvement, medication adherence, and low rate of specialty MH referrals.

scholarly journals Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

2010 ◽  
Vol 2 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Olawale O. Ogunsemi ◽  
Francis A. Oluwole ◽  
Festus Abasiubong ◽  
Adebayo R. Erinfolami ◽  
Olufemi E. Amoran ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Primary Care Settings ◽  
Primary Health ◽  
Patient Health ◽  
The Impact

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

Improving PHQ9 Utilization Rates in a Primary Care–Mental Health Integration Setting

2019 ◽  
Vol 26 (2) ◽  
pp. 206-211
Author(s):  
Margaret J. Brown ◽  
Susie M. Adams ◽  
Dawn Vanderhoef ◽  
Rosanne Schipani ◽  
Ashley Taylor
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Mental Health ◽  
Measurement Based Care ◽  
Mental Health Integration ◽  
Mental Health Settings ◽  
Patient Health ◽  
Standardized Measurement ◽  
Monitor Treatment Response

INTRODUCTION: Measurement-based care (MBC) uses standardized measurement to systematically monitor treatment response over time. Although MBC is underutilized in mental health settings, primary care–mental health integration (PC-MHI) settings are expected to provide MBC. This article describes a quality improvement (QI) process to increase Patient Health Questionnaire-9 (PHQ9) utilization within a PC-MHI setting. AIMS: Pre-intervention, rates of baseline and follow-up PHQ9 administration for veterans with a depressive disorder were 76% and 35%, respectively. This article describes a QI process to increase PHQ9 utilization rates within a PC-MHI setting, with the goal to improve provider PHQ9 utilization rates at baseline and within 4-week follow-up to 90%. METHOD: An educational intervention and weekly motivational enhancement sessions were implemented in 2017. Chart review data compared PHQ9 utilization rates from fall 2016 and 2017. RESULTS: Following intervention, provider PHQ9 utilization rates increased to 98% and 88% at baseline and follow-up. CONCLUSIONS: These findings demonstrate that a brief education-based intervention can increase clinician use of MBC within a PC-MHI setting. Meaningful use of MBC to inform treatment was not evaluated in this QI project and is an area for future investigation.

Successes With Implementation of Primary Care--Mental Health Integration

2009 ◽  
Author(s):  
Paul Heideman ◽  
Douglas Olson ◽  
John P. Billig ◽  
Beret A. Skroch ◽  
Laura L. Meyers
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Mental Health ◽  
Mental Health Integration

Strengthening Core Competencies in VHA Primary Care-Mental Health Integration

2012 ◽  
Author(s):  
Douglas H. Olson ◽  
Beret A. Skroch ◽  
Kathlene A. Scholljegerdes ◽  
Samuel M. Hintz
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Core Competencies ◽  
Primary Care Mental Health ◽  
Mental Health Integration

scholarly journals Online Mental Health Assessments of COVID-19 Patients in South Korea

2021 ◽  
Vol 12 ◽  
Author(s):  
Jung Hyun Lee ◽  
Dayoung Lee ◽  
Soyoen Hyun ◽  
Ji Sun Hong ◽  
Chang-Hoon Kim ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Mental Health Problems ◽  
Health Problems ◽  
Self Report ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Post Traumatic Stress ◽  
Patient Health ◽  
Post Traumatic

Experiences of infectious diseases cause stressful and traumatic life events, hence, coronavirus disease 2019 (COVID-19) patients could suffer from various mental health problems requiring psychological support services. This study investigates the severity of mental health problems among confirmed COVID-19 patients. From March to November 2020, we collected the data from 118 COVID-19 patients who voluntarily participated in the National Center for Disaster Trauma's online mental health assessment consisting of self-report scales like Primary Care of Posttraumatic Stress Disorder screen (PC-PTSD), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and P4 Suicidality Screener. For control, 116 other disaster-experienced and 386 non-COVID-19-experienced participants were recruited. The COVID-19 patients showed more severe symptoms including post-traumatic symptoms, depression, anxiety, and somatic symptoms than control groups across all four screening scales (p < 0.001). Regarding high-risk, COVID-19 patients had an increased association with high-risk compared to the comparison groups (PC-PTSD: OR = 24.16, 95% CI = 13.52–43.16 p < 0.001; PHQ-9: OR = 14.45, 95% CI = 8.29–25.19, p < 0.001; GAD-7: OR=20.71, 95% CI = 10.74–39.96, p < 0.001; PHQ-15: OR = 5.65, 95% CI = 3.44–9.25, p < 0.001; P4: OR = 14.67, 95% CI = 8.95–25.07, p < 0.001). This study's results imply that there is a high-risk of overall mental health problems, especially stronger associations of post-traumatic stress symptoms, in COVID-19 patients. These findings help inform practitioners about the psychological responses to COVID-19 experiences and to prepare appropriate interventions and services for the incremental number of confirmed cases.

Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan

2011 ◽  
Vol 52 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Shen-Ing Liu ◽  
Zai-Ting Yeh ◽  
Hui-Chun Huang ◽  
Fang-Ju Sun ◽  
Jin-Jin Tjung ◽  
...  
Keyword(s):  
Primary Care ◽  
Depression Screening ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health ◽  
Primary Care Patients

A computerized version of the Patient Health Questionnaire-4 as an ultra-brief screening tool to detect emotional disorders in primary care

2018 ◽  
Vol 234 ◽  
pp. 247-255 ◽  
Author(s):  
Antonio Cano-Vindel ◽  
Roger Muñoz-Navarro ◽  
Leonardo Adrián Medrano ◽  
Paloma Ruiz-Rodríguez ◽  
César González-Blanch ◽  
...  
Keyword(s):  
Primary Care ◽  
Emotional Disorders ◽  
Screening Tool ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health ◽  
Brief Screening

scholarly journals A Pilot Study on Using the Patient Health Questionnaire in the Primary Care Setting in Japan

2005 ◽  
Vol 6 (1) ◽  
pp. 9-16
Author(s):  
Kazuhiro Waza ◽  
Graham Antonnette ◽  
Zyzanski Stephen ◽  
Kazuo Inoue ◽  
Masato Sasaki ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

scholarly journals COVID-19-Pandemie: Belastungen des medizinischen Personals

2020 ◽  
Vol 47 (04) ◽  
pp. 190-197 ◽  
Author(s):  
Jens Bohlken ◽  
Friederike Schömig ◽  
Matthias R. Lemke ◽  
Matthias Pumberger ◽  
Steffi G. Riedel-Heller
Keyword(s):  
Mental Health ◽  
Healthcare Worker ◽  
Soziale Unterstützung ◽  
Anxiety Scale ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Letter To The Editor ◽  
Patient Health

Zusammenfassung Ziel Darstellung von Studien zur psychischen Belastung von medizinischem Personal unter Bedingungen der COVID-19-Pandemie. Methodik PubMed-gestützte Suche mit den Stichworten COVID 19“, „stress“, „mental health“, „healthcare worker“, „staff“, „psychiatry“. Eingeschlossen wurden quantitative Studien, (inkl. „Letter to the editor“) zur Belastung des medizinischen Personals im Zeitraum von Januar bis März 2020. Ergebnisse Es wurden 14 Studien mit Klinikpersonal aus Infektionsabteilungen, Abteilungen für Fieberkranke, Abteilungen der Inneren Medizin inklusive Intensivstationen sowie der Chirurgie und Psychiatrie identifiziert. Am häufigsten wurden der Patient Health Questionnaire-9 (PHQ-9), die Self-rating-Anxiety Scale (SAS) und die Impact of Event Scale (IES-R) verwendet. Die Stichprobengröße schwankte zwischen 37 und 1257 Personen des überwiegend pflegerischen und ärztlichen Personals. Der Anteil an COVID-19-nahen Tätigkeiten schwankte zwischen 7,5 % und 100 %. Es wurde eine erhebliche Belastung durch Stresserleben, depressive und ängstliche Symptome berichtet. Schwere Ausprägungsgrade fanden sich bei 2,2–14,5 % der Befragten. Die Ausprägung der psychischen Symptomatik wurde beeinflusst durch Alter, Geschlecht, Berufsgruppe, Fachrichtung, Art der Tätigkeit und die Nähe zu COVID-19-Patienten. Als Mediatorvariablen wurden das Personalmanagement, die präventive Intervention, die Resilienz und vorhandene soziale Unterstützung angesehen. Schlussfolgerung Angesichts der Häufigkeit psychischer Symptome bei medizinischem Personal erscheinen begleitende psychiatrisch-psychotherapeutisch informierte Interventionen notwendig, um eine Bewältigung zu unterstützen. Eine schnell einsetzende Forschung ist in diesem Bereich wünschenswert.

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