Analyzing a Practice Gap Assignment Discussion

Analyzing a Practice Gap Assignment Discussion

Primary care providers come across a large percentage of the population with major depressive disorder (MDD). Yet, the majority of patients with depression are undiagnosed and untreated. The project change is diagnosing MDD using the PHQ-9 tool.   Integration of the PH-9 tool will enable healthcare providers to increase the percentage of MDD in healthcare facilities and thus improve patients’ quality of life by producing positive health come among patients Analyzing a Practice Gap Assignment Discussion.

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Primary care is the major point for accessing healthcare in the United States. Subsequently, primary care providers come across a large percentage of patients with depression and have become responsible for treating depression, majorly as a result of the increase in managed care. Yet, it is estimated that 75 to 85 percent of primary care patients do not receive treatment for depression (Samples et al. (2020)Analyzing a Practice Gap Assignment Discussion.  Blackstone et al. (2022) emphasize that MDD) affects 7 to 8 percent of United States adults at any particular time. However, in primary care, 10 to 15 percent of patients are estimated to be suffering from MDD, although 50 percent of these patients go unrecognized in primary care. Increased preventive measures for MDD can enable patients to be connected to treatment and result in better outcomes.

Low rates of treatment for depression are partly due to low rates of depression identification. According to Samples et al. (2020),   primary care general practitioners correctly identify less than of patients with depression. Nevertheless, patients who fail to meet depression diagnostic criteria are at times misdiagnosed with and treated for depression, which reflects misrecognition of subclinical symptoms or barriers to correct diagnosis. Evidence has revealed that primary care providers record diagnoses for somatic complaints by patients (for instance, headache, insomnia, or fatigue) rather than depression mainly since they are uncertain about the diagnosis Analyzing a Practice Gap Assignment Discussion.

Depression screeners, such as the Patient Health Questionnaire-9(PHQ-9) were designed to lessen diagnostic uncertainty, and the US Preventive Task Force (USPSTF) recommends individuals 12 years and older be routinely screed for depression based on evidence of the usefulness of depression screening in primary care settings.  The USPSTF recognizes the gap in evidence and also critics alarms about unnecessary or inadequate treatment but concludes that the benefits of screening offset potential harm. However, screening for depression is uncommon in primary care settings, implying that primary care providers screen patients under certain situations or continue relying on clinical judgment when making a diagnosis.

Efforts to improve the identification and treatment of depression in primary care include increased utilization of screening tools. According to Levis et al.  (2019), screening for depression is the utilization of depression screening tools to recognize patients who might have depression but are yet to be identified. Clinicians are recommended to administer a depression symptom questionnaire and to utilize a pre-specified cut-off threshold to categorize patients as having negative or positive screening results.  Then, there is the evaluation of patients with positive screening results to establish whether they have depression and if suitable, provided treatment Analyzing a Practice Gap Assignment Discussion.

The PHQ-9 depression symptom questionnaire is recommended for depression screening by the USPSTF.   PHQ-9 is an effective and rapid tool for detecting and also monitoring the severity of depression.  Negeri et al. (2021) posit that PHQ-9 comprises nine items based on the 9 DSM-5 criteria for MDD.  Items, scored zero to three reveal how often a patient has experienced each of the 9 DSM-5 major depression symptoms in the last fourteen days.  10 or greater is the standard cut-off value for identifying major depression.  Besides,  depression screening,  the PHQ- 9 can be used in the assessment and discussion of symptoms with patients who might be uncertain if they are suffering from depression and relapse detection or monitoring for treatment response.

References

Blackstone, S. R., Sebring, A. N., Allen, C., Tan, J. S., & Compton, R. (2022). Improving Depression Screening in Primary Care: A Quality Improvement Initiative. Journal of Community Health,  47, 400-407. https://doi.org/10.1007/s10900-022-01068-6

Levis, B., Benedetti, A., & Thombs, B. D. (2019). Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ, 365, 11476. https://doi.org/10.1136/bmj.l1476

Negeri, Z. F., Levis, B., Sun, Y., He, C., Krishnan, A., Wu, Y., Bhandari, P. M., Neupane, D., Brehaut, E., Benedetti, A., & Thombs, B. D. (2021). Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis. BMJ, 375, n2183. https://doi.org/10.1136/bmj.n2183

Samples, H., Stuart, E. A., Saloner, B., Barry, C. L., & Motabai, R. (2020). The Role of C=Screening in Depression Diagnosis and Treatment in a Representative Sample of US Primary Care Visits. Journal of General Internal Medicine, 35, 12-20. https://doi.org/10.1007/s11606-019-05192-3 Analyzing a Practice Gap Assignment Discussion

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The practice change project is: diagnosing MDD using PHQ-9 tool
The purpose statement is : for example- To produce positive health outcomes among patients, thus improving their quality of life. It intends to achieve this by increasing the percentage of Major Depressive Disorder (MDD) diagnoses in healthcare facilities. Integration of the PHQ-9 tool enables healthcare providers to achieve this goal.
Please review the following previous orders numbers for this essay assignment #238911, 283594, 238328, 238119 Analyzing a Practice Gap Assignment Discussion

Discussion

Purpose

The purpose of this discussion is to analyze a gap in practice, which will serve as the catalyst for the development of the DNP practice change project.

Instructions

Reflect on your readings this week and provide your proposed DNP practice change project purpose statement in one concise sentence.

The statement should clearly identify the following:

1. Gap in practice
2. Population impacted
3. Goal of the project

 

The practice change project is: diagnosing MDD using PHQ-9 tool

The purpose statement is : for example- To produce positive health outcomes among patients, thus improving their quality of life. It intends to achieve this by increasing the percentage of Major Depressive Disorder (MDD) diagnoses in healthcare facilities. Integration of the PHQ-9 tool enables healthcare providers to achieve this goal.

Please review the following previous orders for this essay assignment #238911, 283594, 238328, 238119