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Routine PHQ-9 Depression Screening in Home Health Care: Depression Prevalence, Clinical and Treatment Characteristics, and Screening Implementation
Open accessAbstract
This study aimed to examine: the prevalence and correlates of depression among adults age 65 and over on admission to diverse home health care programs; nurse compliance with routine screening using the PHQ-9; and concordance between the number of depressed individuals identified by the PHQ-9 and Medicare-mandated nursing assessment following targeted nurse training in identifying depression among the elderly using a standard diagnostic screen. Data are drawn from routine screening of 9,178 patients (a 77% screening compliance rate). Of all patients screened, 782 (8.5%) met criteria for probable major depression and 148 (1.6%) for mild depression. Concordance between nurse identified depression via PHQ-9 and OASIS depression assessment improved over that reported in previous studies. Findings suggest that the use of a routine screening tool for depression can be implemented with minimal in-house training and improves detection of depression among older adults with significant physical and functional impairment.
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“Based on effect sizes from these large studies (Ell et al., 2006; Ko et al., 2012, Slade et al., 2011), we determined pre-pandemic rate of depressive symptoms to range from 6.2% to 11.5%.”
From Prevalence rates of anxiety, depressive, and eating pathology symptoms between the pre- and peri-COVID-19 eras: A meta-analysis (2022) · cites this paper as Ell et al., 2006
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“Other brief instruments that have been used successfully in the assessment of old age depression include the Patient Health Questionnaire-Depression Module (PHQ-9) which is a brief tool that scores on each of the nine DSM-IV(282) diagnostic criteria.(283,284) Anxiety is often a central concern of patients with pain pr…”
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Chen, S., Chiu, H. F. K., Xu, B., Ma, Y., Jin, T., Wu, M., & Conwell, Y. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2442 · Cited by 242
“…with depression and monitor the change of their depressive symptoms with treatments (Kroenke et al., 2001; Nease and Maloin, 2003; Lowe et al., 2004a; Lowe et al., 2004b; Ell et al., 2005; Pinto-Meza et al., 2005; Lowe et al., 2006; Esler et al., 2007; Thombs et al., 2007; Wittkampf et al., 2007).”
BackgroundMethod
Metadata
- Authors
- Ell, K., Unützer, J., Aranda, M., Sanchez, K., & Lee, P.-J.
- Affiliations
- University of Southern California (US)
- Venue
- Home Health Care Services Quarterly
- Publisher
- Informa UK Limited
- Published
- 2006-01-24
- Volume
- 24
- Issue
- 4
- Pages
- 1-19
- ISSN
- 0162-1424 (ISSN-L)
- 1545-0856
- PMC
- PMC1421520
- OpenAlex
- W2061868822
- Cited by
- 109
- References
- 49
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 7 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 8 · 2014: 9 · 2013: 5 · 2012: 12
- FWCI
- 8.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Home Health Care Services Quarterly (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (5 R24 MH61700-02, R24MH061700)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
- Keywords
- depression screening, PHQ-9, home health care, older adults, depression prevalence, nurse compliance, screening program implementation, functional disability
- MeSH terms
- Aged, Aged, 80 and over, Community Health Nursing, Depression, Diagnostic Tests, Routine, Female, Home Care Services, Humans, Male, United States, Geriatric Assessment
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