| Description |
Heart failure affects more than 5.7 million Americans (Pressler et. al, 2011) with approximately 500,000 new cases diagnosed annually (Jiang et. al, 2008). Depression is a prevalent comorbidity associated with heart failure (Silver, 2010). Depression in heart failure patients leads to increased mortality, increased morbidity, and a lower quality of life (Jiang et. al, 2011). The life altering prognosis, coupled with physical disability further their risk for developing depression (Thomas et. al, 2008). The American Heart Association currently recommends screening all heart failure patients for depression on a routine basis (Jessup et. al, 2009). However, there is little research indicating whether primary care providers are screening their patients for depression. Research indicates that primary care providers are reluctant to diagnose heart failure patients with depression (Bogner et. al, 2006). Valid and reliable screening tools are available for providers (Thomas et. al, 2008), but are being underutilized (Cully et. al, 2009). Time constraints, lack of mental health knowledge, limited resources, and a lack of treatment options may further add to provider's reluctance to screen for depression in these patients (Cully et. al, 2009). Not only is screening for depression difficult in this population, treatment may be as elusive. Therefore, with a lack of guidelines, providers may be less likely to screen and treat their heart failure patients for depression. The purpose of this project is to present a useful and effective educational module and clinical guideline for the assessment and treatment of depression in adult heart failure patients to primary care providers. This project provides opportunities to educate providers on the methods of assessment and treatment options for these patients. The guideline consists of the Beck Depression Inventory, treatment options, a social support screening tool, and referral resources. The guideline was presented to 5 primary care providers located in 4 separate clinics as an educational module. A short questionnaire was given to the providers prior to the educational module to assess their likelihood of screening and treating depression in heart failure patients. A post assessment questionnaire was given after the presentation to evaluate the efficacy of the educational module. The results of the project indicate that the educational module and clinical guideline are both effective in educating providers on current evaluation and treatment options for this population. Although this quality improvement project had several limitations, it did show promise as all providers indicated they would increase their screening and treatment rates after viewing the guideline and educational module. This project was ground-level, with hopes that further studies will validate the use of this clinical guideline. |
