Post-Partum Depression Screening Mayo Clinic Experience

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Presentation transcript:

Post-Partum Depression Screening Mayo Clinic Experience Brian Lynch, MD May 12,2017 MN AAP Annual State Meeting

Objectives Describe initial implementation of post-partum depression (PPD) screening at Mayo Clinic Discuss challenging issues with PPD screening Outline the current PPD screening process at Mayo Clinic

Initial PPD screening implementation 2 free-standing multispecialty clinics in north Rochester in June-Sept 2009 Maternal screening at 2, 4, and 6 month well visits using the Edinburgh Postnatal Depression Scale (EPDS) Nursing staff collected and scored the form Receptionist provided form to family A positive score was 11 or more or a positive response to question raising concerns about suicide Intervention options: Depression care manager Scheduled visit with mother’s primary care physician On-call psychiatrist or emergency department transfer

Results of the pilot study Compliance rate of 47.9% (n=333) Between family medicine and pediatric providers, there was no difference in screening rates or positive screening results Overall positive screen rate of 4.5%

Next steps after pilot Because PHQ-9 was available in the electronic medical record, switch was made from EPDS in 2010 AAP recommends EPDS Continued screening at the pilot site clinics since 2009 All Mayo Clinic primary care sites in Rochester area will implement PPD screening For all Mayo Clinic sites, the following current recommendation is: Consider doing this screening using PHQ-9 when resources for follow up are available at all well visits up to 12 months of age

Challenging issues when plunging into PPD screening Billing Mayo Clinic is not currently billing CPT 99420 Documentation Mayo legal department recommends that information gathered is in the mother’s medical record

Current PPD screening workflow

Questions?

References http://pediatrics.aappublications.org/content/pediatrics/e arly/2010/10/25/peds.2010-2348.full.pdf Stewart ED, Vigod S. Postpartum Depression. New England Journal of Medicine 2016; 375:2177-2186 Wichman CL, Angstman KB, Lynch BA, Whalen D, Jacobson N. Postpartum Depression Screening: Initial Implementation in a Multispecialty Practice with Collaborative Care Managers. Journal of Primary Care & Community Health 2010; 1(3): 158-163.