Combining Patient-Provided Data, EHR Data Can Improve Care of Patients With Depression

Gathering data in the primary care clinical setting may help family physicians and other primary care professionals improve the care they provide for patients with depression, according to a recent article in the Journal of the American Board of Family Medicine.

The practiced-based study, "Enhancing Electronic Health Record Measurement of Depression Severity and Suicide Ideation," was conducted by the AAFP National Research Network (AAFP NRN) and the DARTNet Institute (formerly the Distributed Ambulatory Research in Therapeutics Network).

Researchers used the DARTNet Institute to systematically collect data at the point of care using the nine-item Patient Health Questionnaire (PHQ-9). Researchers then combined this data with electronic health record (EHR) data to capture, describe, and compare data on baseline severity of illness, suicidality and response, and suicidality after diagnosis for more than 61,000 patients with depression.

The study adds to evidence that severely depressed and suicidal patients are common in primary care settings, said the researchers. It also demonstrates the DARTNet Institute's capability to combine existing EHR information with both prescription fulfillment and PHQ-9 data to enhance clinical care for depression and enable more robust comparative effectiveness research.

"The viability of integrating EHR, prescription fulfillment and PHQ-9 data to provide clinicians with an enriched medical record may enable them to provide higher quality care for depression," the researchers wrote. "Knowledge of baseline severity of illness and suicidality provides a starting point for evaluating the effectiveness of treatment, the need to adjust treatment, and ultimately recognizing patients who have treatment-resistant depression. Better decisions at these key points in the treatment of depression have been shown to improve patient outcomes."

Integrating the prescription fulfillment data also proved that knowledge is power, researchers said, because it allowed clinicians to differentiate between a drug that's not working as well as expected and poor outcomes caused by issues such as patients not filling antidepressant prescriptions regularly or at all.

"The study demonstrates that measurement-based care for depression is both possible and potentially useful in primary care settings," the researchers said.

The AAFP NRN is a voluntary research association of primary care physicians and regional practice-based research networks that collaborate on studies to describe and improve primary care practice. It currently includes more than 2,200 primary care clinician members in some 600 offices and encompasses 49 states and the District of Columbia, as well as four Canadian provinces.