Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care
Background: A tribal health organization in Alaska implemented a primary care depression screening, detection and management initiative amongst 55,000 Alaska Native/American Indian people (AN/AIs). Objectives: (a) To describe the proportion of AN/AIs screening positive for depression with depression...
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ftdoajarticles:oai:doaj.org/article:4d3d5f771dc145ef92a9e88ca2fd5b98 2023-05-15T15:08:50+02:00 Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care Vanessa Y. Hiratsuka Julia J. Smith Sara M. Norman Spero M. Manson Denise A. Dillard 2015-10-01T00:00:00Z https://doi.org/10.3402/ijch.v74.28315 https://doaj.org/article/4d3d5f771dc145ef92a9e88ca2fd5b98 EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/28315/pdf_45 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v74.28315 https://doaj.org/article/4d3d5f771dc145ef92a9e88ca2fd5b98 International Journal of Circumpolar Health, Vol 74, Iss 0, Pp 1-9 (2015) depression Alaska Native/American Indian people primary care Arctic medicine. Tropical medicine RC955-962 article 2015 ftdoajarticles https://doi.org/10.3402/ijch.v74.28315 2022-12-30T22:52:49Z Background: A tribal health organization in Alaska implemented a primary care depression screening, detection and management initiative amongst 55,000 Alaska Native/American Indian people (AN/AIs). Objectives: (a) To describe the proportion of AN/AIs screening positive for depression with depression noted or diagnosed and proportion with guideline concordant management and (b) to assess whether management varied by patient and provider factors. Research design: Secondary analysis of electronic and paper medical record information of 400 AN/AIs. Measures: Provider variables, patient demographics and patient clinical factors were electronically queried. Manual chart audits assessed depression notation, diagnoses and management within 12 weeks of positive screening. Multilevel ordinal logistic modelling assessed management by patient and provider factors. Results: A depression diagnosis was present in 141 (35%) charts and 151 (38%) had depressive symptoms noted. Detection was higher among AN/AIs with moderate and severe depression (p<0.001). In total, 258 patients (66%) received guideline concordant management, 32 (8%) had some management, and 110 (28%) received no management. Younger patient age and increased provider tenure increased odds of management. Conclusions: Most AN/AIs screening positive for depression received initial guideline concordant management. Additional outreach to older patients and additional support for providers newer to practices appears warranted. Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health Alaska Directory of Open Access Journals: DOAJ Articles Arctic Indian International Journal of Circumpolar Health 74 1 28315 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
depression Alaska Native/American Indian people primary care Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
depression Alaska Native/American Indian people primary care Arctic medicine. Tropical medicine RC955-962 Vanessa Y. Hiratsuka Julia J. Smith Sara M. Norman Spero M. Manson Denise A. Dillard Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
topic_facet |
depression Alaska Native/American Indian people primary care Arctic medicine. Tropical medicine RC955-962 |
description |
Background: A tribal health organization in Alaska implemented a primary care depression screening, detection and management initiative amongst 55,000 Alaska Native/American Indian people (AN/AIs). Objectives: (a) To describe the proportion of AN/AIs screening positive for depression with depression noted or diagnosed and proportion with guideline concordant management and (b) to assess whether management varied by patient and provider factors. Research design: Secondary analysis of electronic and paper medical record information of 400 AN/AIs. Measures: Provider variables, patient demographics and patient clinical factors were electronically queried. Manual chart audits assessed depression notation, diagnoses and management within 12 weeks of positive screening. Multilevel ordinal logistic modelling assessed management by patient and provider factors. Results: A depression diagnosis was present in 141 (35%) charts and 151 (38%) had depressive symptoms noted. Detection was higher among AN/AIs with moderate and severe depression (p<0.001). In total, 258 patients (66%) received guideline concordant management, 32 (8%) had some management, and 110 (28%) received no management. Younger patient age and increased provider tenure increased odds of management. Conclusions: Most AN/AIs screening positive for depression received initial guideline concordant management. Additional outreach to older patients and additional support for providers newer to practices appears warranted. |
format |
Article in Journal/Newspaper |
author |
Vanessa Y. Hiratsuka Julia J. Smith Sara M. Norman Spero M. Manson Denise A. Dillard |
author_facet |
Vanessa Y. Hiratsuka Julia J. Smith Sara M. Norman Spero M. Manson Denise A. Dillard |
author_sort |
Vanessa Y. Hiratsuka |
title |
Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
title_short |
Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
title_full |
Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
title_fullStr |
Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
title_full_unstemmed |
Guideline concordant detection and management of depression among Alaska Native and American Indian people in primary care |
title_sort |
guideline concordant detection and management of depression among alaska native and american indian people in primary care |
publisher |
Taylor & Francis Group |
publishDate |
2015 |
url |
https://doi.org/10.3402/ijch.v74.28315 https://doaj.org/article/4d3d5f771dc145ef92a9e88ca2fd5b98 |
geographic |
Arctic Indian |
geographic_facet |
Arctic Indian |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health Alaska |
op_source |
International Journal of Circumpolar Health, Vol 74, Iss 0, Pp 1-9 (2015) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/28315/pdf_45 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v74.28315 https://doaj.org/article/4d3d5f771dc145ef92a9e88ca2fd5b98 |
op_doi |
https://doi.org/10.3402/ijch.v74.28315 |
container_title |
International Journal of Circumpolar Health |
container_volume |
74 |
container_issue |
1 |
container_start_page |
28315 |
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1766340120877727744 |