Collaborative care for depression of adults and adolescents: Measuring the effectiveness of screening and treatment uptake

Abstract

Objective: This study analyzed effectiveness of screening, referrals, and treatment uptake of a collaborative care for depression intervention across 10 primary care clinics in Chicago. Methods: Between November 2016 and December 2017, patients (N=25,369) were screened with the Patient Health Questionnaire-2 and the Patient Health Questionnaire-9 on the basis of an eligibility algorithm. Electronic health record data were analyzed for sample characteristics, screening rates, referrals, and treatment pathways. To identify disparities, a test of proportions was conducted between eligible and screened patients as well as referred and treated patients. Results: Screenings, referrals, and uptake occurred proportionately across subgroups except for patients ages 12-17. Adolescent age was associated with disproportionate Patient Health Questionnaire-9 screenings and with treatment disengagement. Conclusions: The intervention shows promise in expanding access to care and reducing disparities. Greater access to psychotherapies and innovative treatment modalities, particularly for adolescents, may improve overall treatment uptake.