Challenges and Implications of Routine Depression Screening for Depression in Chronic Disease and Multimorbidity: A Cross Sectional Study
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{"title"=>"Challenges and Implications of Routine Depression Screening for Depression in Chronic Disease and Multimorbidity: A Cross Sectional Study", "type"=>"journal", "authors"=>[{"first_name"=>"Bhautesh Dinesh", "last_name"=>"Jani", "scopus_author_id"=>"55190844300"}, {"first_name"=>"David", "last_name"=>"Purves", "scopus_author_id"=>"7005389062"}, {"first_name"=>"Sarah", "last_name"=>"Barry", "scopus_author_id"=>"8314911000"}, {"first_name"=>"Jonathan", "last_name"=>"Cavanagh", "scopus_author_id"=>"35597404500"}, {"first_name"=>"Gary", "last_name"=>"McLean", "scopus_author_id"=>"13807492700"}, {"first_name"=>"Frances S.", "last_name"=>"Mair", "scopus_author_id"=>"7004850729"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84884129712", "pui"=>"369813476", "doi"=>"10.1371/journal.pone.0074610", "isbn"=>"1932-6203", "sgr"=>"84884129712", "pmid"=>"24058602"}, "id"=>"87bf3d3f-83c5-3b84-963a-281653f2739c", "abstract"=>"BACKGROUND: Depression screening in chronic disease is advocated but its impact on routine practice is uncertain. We examine the effects of a programme of incentivised depression screening in chronic disease within a UK primary care setting. METHODS AND FINDINGS: Cross sectional analysis of anonymised, routinely collected data (2008-9) from family practices in Scotland serving a population of circa 1.8 million. Primary care registered patients with at least one of three chronic diseases, coronary heart disease, diabetes and stroke, underwent incentivised depression screening using the Hospital Anxiety and Depression Score (HADS). 125143 patients were identified with at least one chronic disease. 10670 (8.5%) were under treatment for depression and exempt from screening. Of remaining, HADS were recorded for 35537 (31.1%) patients. 7080 (19.9% of screened) had raised HADS (>/=8); majority had indications of mild depression with HADS between 8 and 10. Over 6 months, 572 (8%) of those with raised HADS (>/=8) were initiated on antidepressants, while 696 (2.4%) patients with normal HADS (<8) were also initiated on antidepressants (relative risk of antidepressant initiation with raised HADS 3.3 (CI 2.97-3.67), p value <0.0001). Of those with multimorbidity who were screened, 24.3% had raised HADS (>/=8). A raised HADS was more likely in females, socioeconomically deprived, multimorbid or younger (18-44) individuals. Females and 45-64 years old were more likely to receive antidepressants. LIMITATIONS: retrospective study of routinely collected data. CONCLUSIONS: Despite incentivisation, only a minority of patients underwent depression screening, suggesting that systematic depression screening in chronic disease can be difficult to achieve in routine practice. Targeting those at greatest risk such as the multimorbid or using simpler screening methods may be more effective. Raised HADS was associated with higher number of new antidepressant prescriptions which has significant resource implications. The clinical benefits of such screening remain uncertain and merits investigation.", "link"=>"http://www.mendeley.com/research/challenges-implications-routine-depression-screening-depression-chronic-disease-multimorbidity-cross-3", "reader_count"=>25, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>2, "Student > Master"=>4, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>2, "Student > Master"=>4, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>7, "Agricultural and Biological Sciences"=>1, "Psychology"=>9, "Social Sciences"=>2, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Social Sciences"=>{"Social Sciences"=>2}, "Psychology"=>{"Psychology"=>9}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>3}}, "reader_count_by_country"=>{"United Kingdom"=>1}, "group_count"=>5}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1203818", "https://ndownloader.figshare.com/files/1203819"], "description"=>"<div><p>Background</p><p>Depression screening in chronic disease is advocated but its impact on routine practice is uncertain. We examine the effects of a programme of incentivised depression screening in chronic disease within a UK primary care setting.</p> <p>Methods and Findings</p><p>Cross sectional analysis of anonymised, routinely collected data (2008-9) from family practices in Scotland serving a population of circa 1.8 million. Primary care registered patients with at least one of three chronic diseases, coronary heart disease, diabetes and stroke, underwent incentivised depression screening using the Hospital Anxiety and Depression Score (HADS).</p> <p>125143 patients were identified with at least one chronic disease. 10670 (8.5%) were under treatment for depression and exempt from screening. Of remaining, HADS were recorded for 35537 (31.1%) patients. 7080 (19.9% of screened) had raised HADS (≥8); majority had indications of mild depression with HADS between 8 and 10. Over 6 months, 572 (8%) of those with raised HADS (≥8) were initiated on antidepressants, while 696 (2.4%) patients with normal HADS (<8) were also initiated on antidepressants (relative risk of antidepressant initiation with raised HADS 3.3 (CI 2.97-3.67), p value <0.0001). Of those with multimorbidity who were screened, 24.3% had raised HADS (≥8). A raised HADS was more likely in females, socioeconomically deprived, multimorbid or younger (18-44) individuals. Females and 45-64 years old were more likely to receive antidepressants.</p> <p>Limitations</p><p>retrospective study of routinely collected data.</p> <p>Conclusions</p><p>Despite incentivisation, only a minority of patients underwent depression screening, suggesting that systematic depression screening in chronic disease can be difficult to achieve in routine practice. Targeting those at greatest risk such as the multimorbid or using simpler screening methods may be more effective. Raised HADS was associated with higher number of new antidepressant prescriptions which has significant resource implications. The clinical benefits of such screening remain uncertain and merits investigation.</p> </div>", "links"=>[], "tags"=>["implications", "sectional"], "article_id"=>798906, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Bhautesh Dinesh Jani", "David Purves", "Sarah Barry", "Jonathan Cavanagh", "Gary McLean", "Frances S. Mair"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0074610.s001", "https://dx.doi.org/10.1371/journal.pone.0074610.s002"], "stats"=>{"downloads"=>4, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Challenges_and_Implications_of_Routine_Depression_Screening_for_Depression_in_Chronic_Disease_and_Multimorbidity_A_Cross_Sectional_Study_/798906", "title"=>"Challenges and Implications of Routine Depression Screening for Depression in Chronic Disease and Multimorbidity: A Cross Sectional Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-09-13 01:32:06"}
  • {"files"=>["https://ndownloader.figshare.com/files/1203812"], "description"=>"<p>Flow chart showing the outcome of depression screening.</p>", "links"=>[], "tags"=>[], "article_id"=>798900, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Bhautesh Dinesh Jani", "David Purves", "Sarah Barry", "Jonathan Cavanagh", "Gary McLean", "Frances S. Mair"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0074610.g002", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_chart_showing_the_outcome_of_depression_screening_/798900", "title"=>"Flow chart showing the outcome of depression screening.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-09-13 01:32:06"}
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  • {"unique-ip"=>"13", "full-text"=>"15", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2020", "month"=>"3"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"4"}
  • {"unique-ip"=>"13", "full-text"=>"15", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"5"}
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  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"7"}
  • {"unique-ip"=>"8", "full-text"=>"5", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2020", "month"=>"8"}
  • {"unique-ip"=>"7", "full-text"=>"8", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2020", "month"=>"9"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"10"}
  • {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"4", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"12"}
  • {"unique-ip"=>"7", "full-text"=>"5", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2021", "month"=>"1"}

Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences", "average_usage"=>[264, 460, 584, 692, 794, 887, 978, 1067, 1154, 1241, 1328, 1408, 1474]}, {"subject_area"=>"/Medicine and health sciences/Diagnostic medicine", "average_usage"=>[244, 425, 535, 636, 728, 814, 900, 982, 1063, 1139, 1221, 1296, 1361]}, {"subject_area"=>"/Medicine and health sciences/Mental health and psychiatry", "average_usage"=>[282, 468, 596, 706, 804, 895, 1000, 1081, 1175, 1272, 1356, 1445, 1531]}, {"subject_area"=>"/Medicine and health sciences/Metabolic disorders", "average_usage"=>[254, 466, 587, 690, 790, 885, 983, 1063, 1139, 1216, 1297, 1373, 1442]}, {"subject_area"=>"/Medicine and health sciences/Public and occupational health", "average_usage"=>[291, 491, 610, 723, 817, 906, 991, 1071, 1153, 1238, 1324, 1411, 1478]}, {"subject_area"=>"/People and places/Demography", "average_usage"=>[253, 440, 552, 650, 735, 820, 902, 976, 1042, 1112, 1192, 1271, 1337]}, {"subject_area"=>"/People and places/Geographical locations", "average_usage"=>[263, 456, 571, 673, 776, 866, 955, 1040, 1132, 1217, 1310, 1391, 1454]}]}
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