TY - JOUR
T1 - Primary care physician recognition and documentation of depressive symptoms among chinese and latinx patients during routine visits
T2 - A cross-sectional study
AU - Garcia, Maria E.
AU - Hinton, Ladson
AU - Gregorich, Steven E.
AU - Livaudais-Toman, Jennifer
AU - Kaplan, Celia P.
AU - Feldman, Mitchell
AU - Karliner, Leah
N1 - Funding Information:
Dr. Garcia received support from the University of California, Davis (UC Davis RCMAR/Latinx Aging Research Resource Center) under NIH/NIA Grant P30-AG043097; the Research in Implementation Science for Equity (RISE) Program, funded by NHLBI grant R25HL126146, the NHLBI K12HL138046, the Center for Aging in Diverse Communities (CADC) funded by NIH/NIH Grant P30-AG015272, and through an NIMHD K23MD015115; the content does not necessarily represent the official views of the NIA, NHLBI, NIMHD, or NIH. Dr. Garcia also wishes to thank SF BUILD (Building Infrastructure Leading to Diversity) for their support in the preparation of the article at a writing retreat. SF BUILD is funded by linked grants through the NIH Common Fund: UL1 GM118985; TL4 GM118986; and RL5GM118984. Research reported in this article was funded through a Patient-Centered Outcomes Research Institute® (PCORI®) award (AD-1409-23627).
Publisher Copyright:
© Maria E. Garcia et al., 2021; Published by Mary Ann Liebert, Inc. 2021.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Purpose: Asian and Latinx individuals have a high burden of untreated depression. Under-recognition of depressive symptoms may contribute to existing disparities in depression treatment. The objective of this cross-sectional study was to determine whether physicians recognize and treat depressive symptoms for Chinese and Latinx patients during routine primary care visits. Methods: We analyzed data from 1171 Chinese and Latinx patients who were interviewed within 1 week after a primary care visit in a large academic practice, which had not yet implemented universal depression screening. We included participants with depressive symptoms (defined as a Patient Health Questionaire-2 score ≥3) and no prior history of depression (N=118). We investigated whether patients perceived having a mental health need in the prior year and conducted chart reviews to assess provider recognition of depressive symptoms, defined as documentation of symptoms, antidepressant initiation, or mental health referral within 30 days of the visit. We further examined differences by race/ethnicity and language preference. Results: Among the 118 patients with depressive symptoms and no prior depression diagnosis (mean age 68), 71 (61%) reported a mental health need in the prior 12 months; however, providers recognized depressive symptoms in only 8/118 patients (7%). The number of patients with recognized symptoms was small across race/ethnicity and language preference groups and we found no significant differences. Conclusion: Physicians recognized and documented depressive symptoms for 1 in 10 Chinese and Latinx patients during routine primary care visits. Targeted efforts are needed to address under-recognition of symptoms and improve depression care for these populations.
AB - Purpose: Asian and Latinx individuals have a high burden of untreated depression. Under-recognition of depressive symptoms may contribute to existing disparities in depression treatment. The objective of this cross-sectional study was to determine whether physicians recognize and treat depressive symptoms for Chinese and Latinx patients during routine primary care visits. Methods: We analyzed data from 1171 Chinese and Latinx patients who were interviewed within 1 week after a primary care visit in a large academic practice, which had not yet implemented universal depression screening. We included participants with depressive symptoms (defined as a Patient Health Questionaire-2 score ≥3) and no prior history of depression (N=118). We investigated whether patients perceived having a mental health need in the prior year and conducted chart reviews to assess provider recognition of depressive symptoms, defined as documentation of symptoms, antidepressant initiation, or mental health referral within 30 days of the visit. We further examined differences by race/ethnicity and language preference. Results: Among the 118 patients with depressive symptoms and no prior depression diagnosis (mean age 68), 71 (61%) reported a mental health need in the prior 12 months; however, providers recognized depressive symptoms in only 8/118 patients (7%). The number of patients with recognized symptoms was small across race/ethnicity and language preference groups and we found no significant differences. Conclusion: Physicians recognized and documented depressive symptoms for 1 in 10 Chinese and Latinx patients during routine primary care visits. Targeted efforts are needed to address under-recognition of symptoms and improve depression care for these populations.
KW - Depression recognition
KW - Depression treatment
KW - Depressive symptoms
KW - Language barriers
KW - Limited English proficiency
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U2 - 10.1089/heq.2020.0104
DO - 10.1089/heq.2020.0104
M3 - Article
AN - SCOPUS:85104954648
VL - 5
SP - 236
EP - 244
JO - Health Equity
JF - Health Equity
SN - 2473-1242
IS - 1
ER -