Faculty Bibliography
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STRENGTHENING THE PRIMARY CARE PIPELINE: LESSONS LEARNED FROM A PRE- HEALTH VOLUNTEER PROGRAM THAT ENGAGES STUDENTS IN AN URBAN, UNDER-SERVED CLINIC [Meeting Abstract]
ISI:000567143602377
ISSN: 0884-8734
CID: 4799372
Depression screening of adult asian patients in an urban safety-net primary care clinic [Meeting Abstract]
Background: Depression and suicide rates among Asian Americans are high, making them the only racial group in New York City for whom suicide is one of the top ten causes of death. The underutilization of mental health services by Asians compared to other ethnic groups is a disparity likely attributed to the strong stigma around mental illness and poor self-recognition of depression. Universal depression screening in primary care has led to increased detection and treatment of depression in all patients. We sought to understand the prevalence of depression through completion of the Patient Health Questionnaire (PHQ2) screener among Asian primary care patients at a large, urban, tertiary safety-net medical center.
Method(s): In our cross-sectional study we analyzed a registry of patients who identified their race as " Asian" and visited our primary care clinic (Bellevue Hospital Adult Primary Care Clinic) from July through December 2016. Chart review was performed to assess the completion and response rates of the Patient Health Questionnaire (PHQ2) and determine prevalence of depression. When possible, we identified countries of origin for each patient.
Result(s): We identified a total of 1105 Asian patients. Regions of origin included East Asia (27.7%), Indian Subcontinent (29.3%), Southeast Asia (25.2%). Countries most represented were China, Bangladesh, the Philippines, and Tibet. For 11% of patients, there was no documentation of country of origin. PHQ2 completion rates by country were comparable to our overall clinic screening rate of 64%: China 65.0%, Bangladesh 67.5%, Philippines 64.1%, Tibet 61.3%. The rates of positive PHQ2 scores were: China 6.4%, Bangladesh 7.3%, Philippines 4.9%, Tibet 7.4%, comparable to the national depression rate of 8%. For English-speakers compared to non-English speakers, the rates of PHQ2 completion varies: China 65.8% vs. 64.9%, Tibet 68.8% vs. 57.1%, Bangladesh 64.0% vs. 70.8%, Philippines 63.1% vs. 80.0%. Of the positive PHQ2 screens, 72.7% of the Chinese patients had PHQ9 scores 10 or higher, indicating moderate depression or worse, as did 92.3% of Bengali, 16% of Tibetan, and 60% of Filipino patients.
Conclusion(s): Disparities in mental health screening and treatment continue to affect the Asian immigrant population, in part driven by culture and language differences. In our large, safety-net primary care clinic, the completion rate for depression screens among Asians are similar to the clinic's overall monthly PHQ2 screening rate of 64%. This analysis indicates that Asian patients in our clinic who screen positive on the PHQ9 may have moderate to severe depression, consistent with the phenomenon that depression in Asians is often under-detected, and therefore undertreated. Further studies are needed to assess the role of culture and language on depression screening for each Asian sub-group. We are conducting further analysis to review the rates of depression diagnosis and treatment patterns in this population
Method(s): In our cross-sectional study we analyzed a registry of patients who identified their race as " Asian" and visited our primary care clinic (Bellevue Hospital Adult Primary Care Clinic) from July through December 2016. Chart review was performed to assess the completion and response rates of the Patient Health Questionnaire (PHQ2) and determine prevalence of depression. When possible, we identified countries of origin for each patient.
Result(s): We identified a total of 1105 Asian patients. Regions of origin included East Asia (27.7%), Indian Subcontinent (29.3%), Southeast Asia (25.2%). Countries most represented were China, Bangladesh, the Philippines, and Tibet. For 11% of patients, there was no documentation of country of origin. PHQ2 completion rates by country were comparable to our overall clinic screening rate of 64%: China 65.0%, Bangladesh 67.5%, Philippines 64.1%, Tibet 61.3%. The rates of positive PHQ2 scores were: China 6.4%, Bangladesh 7.3%, Philippines 4.9%, Tibet 7.4%, comparable to the national depression rate of 8%. For English-speakers compared to non-English speakers, the rates of PHQ2 completion varies: China 65.8% vs. 64.9%, Tibet 68.8% vs. 57.1%, Bangladesh 64.0% vs. 70.8%, Philippines 63.1% vs. 80.0%. Of the positive PHQ2 screens, 72.7% of the Chinese patients had PHQ9 scores 10 or higher, indicating moderate depression or worse, as did 92.3% of Bengali, 16% of Tibetan, and 60% of Filipino patients.
Conclusion(s): Disparities in mental health screening and treatment continue to affect the Asian immigrant population, in part driven by culture and language differences. In our large, safety-net primary care clinic, the completion rate for depression screens among Asians are similar to the clinic's overall monthly PHQ2 screening rate of 64%. This analysis indicates that Asian patients in our clinic who screen positive on the PHQ9 may have moderate to severe depression, consistent with the phenomenon that depression in Asians is often under-detected, and therefore undertreated. Further studies are needed to assess the role of culture and language on depression screening for each Asian sub-group. We are conducting further analysis to review the rates of depression diagnosis and treatment patterns in this population
EMBASE:629003885
ISSN: 1525-1497
CID: 4052732
