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

Top Stroke Rehabil. 2019 Jan;26(1):6-17. doi: 10.1080/10749357.2018.1536096. Epub 2018 Oct 22.

Abstract

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.

Keywords: Best practices; depression; depression screening; outpatients; post stroke depression; rehabilitation; stroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Canada / epidemiology
  • Cohort Studies
  • Depression / drug therapy
  • Depression / etiology*
  • Depression / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination
  • Outpatients
  • Patient Compliance
  • Statistics, Nonparametric
  • Stroke / complications*
  • Stroke Rehabilitation*
  • Surveys and Questionnaires

Substances

  • Antidepressive Agents