CAse-fInding foR depressiOn in primary care (CAIRO)

Sarah A Lawton, Christian D Mallen, Carolyn A Chew-Graham, Tom Kingstone, Sarah Lewis, Ram Bajpai, Sara Muller, Toby Helliwell

Background:

Depression is a significant determinant of quality of life, a leading cause of disability and a major contributor to the disease burden worldwide. The prevalence of depressive symptoms in a consulting primary care adult population is unknown.

Research questions:

What proportion of patients screen positive for depression, whilst self-completing an automated check-in screen prior to any general practice (GP) consultation?

Method:

The use of automated check-in screens to collect brief research data, examined the number of patients screening positive for depression, using the validated Whooley questions: (1) Have you felt down or depressed or hopeless? and (2) Have you been bothered by little interest or pleasure in doing things? - in the past month. Patients ≥18 years, with a pre-booked appointment, during a 3-week recruitment period, at 10 GPs in the West Midlands, England, were eligible. Responses to the two additional research questions were added to the patients’ electronic medical record. Descriptive statistics were used to analyse and present data.

Results:

41.1% (n=3,666) of patients with a booked appointment (n=8,913) participated in the CAIRO Study, 61.1% (n=2,239) female, mean age 55.0 years (18-96 years, SD=18.5). 19.1% (n=700) of participants screened positive to both of the Whooley questions, potentially indicating depression. Significantly more positive responses were obtained from females, those aged between 35-49 years and those from more deprived practices. Recruiting GPs to host the study was challenging.

Conclusions:

A positive response does not indicate a diagnosis of depression but indicates that further exploration is needed. One in five (19.1%) CAIRO participants provided a positive response to the Whooley questions, suggesting a level of un-met need. Further investigation is required on why the recruitment of general practices to this study was challenging.

Points for discussion:

This study provides a snapshot of primary care consulting patients’ mental health status and highlights a potential un-met need.

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