Background: Children with chronic health conditions have higher rates of mental illness compared to peers without health conditions. Ghanizadeh et al. reported a 6% rate of major depressive disorder in children diagnosed with hemophilia. Adults who experienced a venous thromboembolism report significant stress and anxiety.
The U.S. Preventive Services Task Force recommends screening for major depressive disorder in patients 12 to 18 years of age in the primary care setting. Our Pediatric Coagulation Disorder Program piloted a depression and anxiety screening protocol for 7 weeks. We surveyed providers to assess the screening process.
Aims: To identify gaps of the mental health screening process for continued process improvement.
Methods: The 4-item Patient Health Questionnaire for anxiety and depression (PHQ-4), PHQ 9-item depression module, Generalized Anxiety Disorder 7-item scale (GAD-7), and Columbia-Suicide Severity Rating Scale (C-SSRS) were utilized. (Figure 1) Electronic medical records of patients ≥12 years were reviewed to determine if a screening was performed. An anonymous electronic survey was emailed to providers inquiring about the screening process.
Results: 70 patients were seen during the 7-week pilot. 38 were > 12 years of age. 33 (87%) were screened, 2 did not require a screen (screened within the last two weeks, seeing psychologist on the same visit), 2 refused, and 1 was missed. Two patients scored ≥ 1 on question 9 of PHQ-4 which is the suicide indicator. The S.A.F.E protocol was initiated on one of these occasions. Urgent referrals were not required during this 7-week pilot. 11 providers were emailed the survey. 82% of providers completed the survey. (Figure 2)
Conclusions: Majority of providers responded that the mental health screening was important, not disruptive nor a burden. Future initiatives will aim to impart knowledge and skills to providers in order for them to be confident in caring for patients who express anxiety or depressive symptoms.
To cite this abstract in AMA style:Braunreiter C, Marietta E, Pentoney S, Vanderwal L, Kurt B, Bowden J. Depression and Anxiety Screening in a Pediatric Coagulation Disorder Program: A Brief Description of a 7-week Pilot [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/depression-and-anxiety-screening-in-a-pediatric-coagulation-disorder-program-a-brief-description-of-a-7-week-pilot/. Accessed September 24, 2021.
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