DEPRESSION SCREENING AMONG PERINATAL PATIENTS WITH AND WITHOUT SUBSTANCE USE DISORDERS FOLLOWING IMPLEMENTATION OF A COLLABORATIVE CARE PROGRAM
Recommended Citation
Yeh H, Elsiss F, Furman K, Hecht L, Corriveau W, Loree A. DEPRESSION SCREENING AMONG PERINATAL PATIENTS WITH AND WITHOUT SUBSTANCE USE DISORDERS FOLLOWING IMPLEMENTATION OF A COLLABORATIVE CARE PROGRAM. Drug Alcohol Depend 2024; 260:110053.
Document Type
Conference Proceeding
Publication Date
7-1-2024
Publication Title
Drug Alcohol Depend
Abstract
Aim: The Perinatal Behavioral Health Integration initiative (PBHI) is a telehealth-based collaborative care program implemented within a large integrated healthcare system. Aims of PBHI included: increasing depression screening rates among all perinatal patients and improving access to care for patients with mental health (MH) conditions, particularly for high-risk subgroups such as those with substance use disorder (SUD). The purpose of this study was to compare changes in screening rates pre- vs. post-implementation and to examine potential differences in screening rates related to history of MH and SUD diagnosis. Methods: Patients who were pregnant or up to 1 year postpartum were eligible for screening using standardized depression screening tools (e.g., PHQ-9); screening was conducted as part of routine care. We examined screening rates between 1/1/2019-3/31/2020 (i.e., pre-implementation) and 4/1/2020-12/31/2021 (i.e., post-implementation). Using ICD-10 diagnostic codes, patients were grouped into 4 groups: 1) without MH or SUD, 2) MH only, 3) SUD only, and 4) MH and SUD. A total of 24,456 perinatal patients who had delivery between 2019 and 2021 were included. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated by logistic regression to compare screening rates in the pre- and post-implementation time periods. Results: Depression screening increased after implementing PBHI. Patients with MH or SUD had higher depression screening prevalence pre-implementation (35%-50%) compared to those without MH or SUD (13%-50%). Adjusting for sociodemographic factors, depression screening increased by 91% post-implementation among patients without MH or SUD (aPR = 1.91, 95% CI: 1.79-2.04). Screening increased by 46% among those with SUD, and increased by 12% among those with both MH and SUD. Conclusions: The PBHI initiative increased depression screening rates among perinatal patients. Patients with MH or SUD had higher rates of depression screening pre- and post-implementation compared to those without a diagnosis. Findings have implications for universal screening and identification among perinatal patients. Financial Support: Ethel and James Flinn Foundation
Volume
260
First Page
110053
