Screening Adherence for Depression Post Stroke: Evaluation of Outpatients, a London Experience (SAD PEOPLE)

• Published in: Topics in stroke rehabilitation 2019-01, Vol.26 (1), p.6-17
• Main Authors: MacKenzie, Heather M, Rice, Danielle, Teasell, Robert, Macaluso, Steven
• Format: Article
• Language: English
• Subjects: Best practices; depression; depression screening; outpatients; post stroke depression; rehabilitation; stroke
• ISSN: 1074-9357; 1945-5119
• DOI: 10.1080/10749357.2018.1536096

Background: Post stroke depression (PSD) is common, and the transition home following discharge may be especially challenging for stroke survivors. Objectives: This study aimed to determine how well specific Canadian Best Practice Recommendations for PSD screening were adopted within a stroke rehabilitation outpatient clinic before and after the utilization of a standardized clinical form. Methods: Practices were evaluated through retrospective chart review before and after the implementation of the standardized form which cued physicians to administer the Patient Health Questionnaire 9 (PHQ-9) at the first outpatient visit. Participants included those aged ≥18 years with a primary diagnosis of stroke. Results: One hundred thirty-five subjects' charts were reviewed. Form implementation was associated with increased rates of PSD screening (93.8% versus 0%) and charting regarding mood (55.4% versus 15.7%). Conclusion: This study highlights the frequency of depressive symptoms in an outpatient cohort and demonstrates how screening rates can be improved by using a standardized form. Routine PHQ-9 completion at the first outpatient visit was associated with more physician-patient discussion and documentation regarding mood.