Artangela Henry, DNP, AGACNP-BC, FNP-C; Laura Reed DNP, FNP-BC; Margaret Harvey PhD, APRN, ACNP-BC, CHFN
Family Practice Nursing | Psychiatric and Mental Health | Quality Improvement
Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting.
In this retrospective chart review, 29 charts of patients ages 18 and older diagnosed with DM2 were assessed to determine if a depression screening was completed. For subjects who met the study’s inclusion criteria, we obtained the sex, age, whether the patient was screened for depression at the office visit, and if they were screened, which depression screening tool was utilized.
Between November 15, 2018, and November 8, 2021, 29 patients met the inclusion criteria for our retrospective chart review. In total, the patients were seen for a total of 102 visits, with 68% of patients screened for depression using either the PHQ-2 or the PHQ-9 screening tool. The average number of visits per patient was 3.5 visits. The average age of the patients was 52.8, with a median age of 51. Twenty-one of the subjects were female, while eight were male.
Implications for Nursing Practice
Based on the data collected, more research is needed to determine if the utilization of a screening tool such as the PHQ-2 and PHQ-9 would indeed be beneficial in treating depression in patients with chronic diseases such as diabetes. Confounding variables that hindered obtaining sufficient data include clinic participation in screening, readily available screening forms, and time constraints. Additionally, variables that could have resulted in a more robust study include a larger sample size, the collection of the patient’s ethnicity, hemoglobin A1c, PHQ-2, and PHQ-9 scores, and the initiation or referral for psychiatric treatment. Further areas of research are needed to determine the benefits of screening for depression in patients with chronic diseases such as diabetes.
Book, Hanna; Eldridge, Kennedy; Harvey, Margaret PhD, APRN, ACNP-BC, CHFN; Henry, Artangela DNP, AGACNP-BC, FNP-C; and Reed, Laura DNP, FNP-BC , "The Utilization of Depression Screening Tools in Patients with Diabetes Type 2" (2023). Doctor of Nursing Practice Projects. Paper 49. http://dx.doi.org/10.21007/con.dnp.2023.0049.