The Systematic Utilization of a Depression Screening Tool for Patients with Type 2 Diabetes: A Quality Improvement Project

Abstract

Depression seen in individuals with diabetes mellitus (DM) is associated with DM complications and increased healthcare costs. To mitigate these complications, the American Diabetes Association recommends that providers screen individuals with DM at least annually. However, routine depression screenings are not consistently performed for patients with type 2 diabetes (T2D). The purpose of this Doctor of Nursing Practice project was to implement a quality improvement (QI) project which focused on systematically screening adult patients with T2D in primary care for depression so that depressive symptoms could be identified, treated, and referred earlier. A retrospective chart review was conducted to explore the depression screening frequencies in the pre- and post-implementation periods. The Academic Center for Evidence-Based Practice Star Model was used to organize the implementation of the QI project. The Theory of Planned Behavior was used to assess the provider's willingness to adopt consistent depression screening practices which guided the implementation process. Patients who qualified were meant to be screened with the Beck Depression Inventory-2 tool during their annual wellness visit. The results revealed an increase in depression screenings for adult patients with T2D (n=41) from 15% to 61%. In addition, 30% of participants had positive depressive screening results compared to 0% in the pre-implementation group, and 14% were referred or began antidepressant treatment. These results suggest that the systematic utilization of a depression screening tool by providers in primary care does improve the frequency of depression screening and early identification of depression among individuals with T2D.