Abstract
Objective We examined rheumatologists' approaches to and perceptions of depression in everyday practice. Methods A questionnaire was mailed to 470 practicing rheumatologists in California; 226 were included in the final analyses. Respondents provided information on demographics, practice characteristics, and attitudes, perceptions, and practices related to depression. Logistic regression models were constructed to assess the relationship of rheumatologists' personal and practice characteristics with their depression-related practices. Results Fifty-one percent of respondents reported that at least half of their patients had depression. Nearly all providers (99%) reported addressing mental health issues during some visits. Rheumatologists were about equally likely to prescribe antidepressants, refer to a psychiatrist, or return the patient to the primary care physician, with roughly 60% often applying each of the 3 strategies. Respondents identified access to services and patients' resistance to mental health diagnoses as major barriers to effective depression management. In logistic regression models, greater number of patient visits per week, greater percentage of patients with fibromyalgia, and private practice setting were associated with more prescription of antidepressants (P < 0.05). Conclusions Depression is common in rheumatologic practice, yet systems for identification, treatment, and referral of depressed patients are not universal. Rheumatologists' awareness of the need for mental health services is high, but they may lack the confidence, time, and/or referral networks to provide consistently effective care for depressed patients. Improving depression care in rheumatology may require a combination of clinician-level interventions (e.g., enhanced behavioral health training) and practice-level reforms (e.g., collaborative care).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 307-311 |
| Number of pages | 5 |
| Journal | Journal of Clinical Rheumatology |
| Volume | 22 |
| Issue number | 6 |
| DOIs | |
| State | Published - Sep 1 2016 |
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Keywords
- depression
- health care providers
- rheumatology
ASJC Scopus subject areas
- Rheumatology
Cite this
Rheumatologists' approaches to diagnosis and treatment of depression. / Heiman, Erica; Kravitz, Richard L; Wise, Barton L.
In: Journal of Clinical Rheumatology, Vol. 22, No. 6, 01.09.2016, p. 307-311.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rheumatologists' approaches to diagnosis and treatment of depression
AU - Heiman, Erica
AU - Kravitz, Richard L
AU - Wise, Barton L
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Objective We examined rheumatologists' approaches to and perceptions of depression in everyday practice. Methods A questionnaire was mailed to 470 practicing rheumatologists in California; 226 were included in the final analyses. Respondents provided information on demographics, practice characteristics, and attitudes, perceptions, and practices related to depression. Logistic regression models were constructed to assess the relationship of rheumatologists' personal and practice characteristics with their depression-related practices. Results Fifty-one percent of respondents reported that at least half of their patients had depression. Nearly all providers (99%) reported addressing mental health issues during some visits. Rheumatologists were about equally likely to prescribe antidepressants, refer to a psychiatrist, or return the patient to the primary care physician, with roughly 60% often applying each of the 3 strategies. Respondents identified access to services and patients' resistance to mental health diagnoses as major barriers to effective depression management. In logistic regression models, greater number of patient visits per week, greater percentage of patients with fibromyalgia, and private practice setting were associated with more prescription of antidepressants (P < 0.05). Conclusions Depression is common in rheumatologic practice, yet systems for identification, treatment, and referral of depressed patients are not universal. Rheumatologists' awareness of the need for mental health services is high, but they may lack the confidence, time, and/or referral networks to provide consistently effective care for depressed patients. Improving depression care in rheumatology may require a combination of clinician-level interventions (e.g., enhanced behavioral health training) and practice-level reforms (e.g., collaborative care).
AB - Objective We examined rheumatologists' approaches to and perceptions of depression in everyday practice. Methods A questionnaire was mailed to 470 practicing rheumatologists in California; 226 were included in the final analyses. Respondents provided information on demographics, practice characteristics, and attitudes, perceptions, and practices related to depression. Logistic regression models were constructed to assess the relationship of rheumatologists' personal and practice characteristics with their depression-related practices. Results Fifty-one percent of respondents reported that at least half of their patients had depression. Nearly all providers (99%) reported addressing mental health issues during some visits. Rheumatologists were about equally likely to prescribe antidepressants, refer to a psychiatrist, or return the patient to the primary care physician, with roughly 60% often applying each of the 3 strategies. Respondents identified access to services and patients' resistance to mental health diagnoses as major barriers to effective depression management. In logistic regression models, greater number of patient visits per week, greater percentage of patients with fibromyalgia, and private practice setting were associated with more prescription of antidepressants (P < 0.05). Conclusions Depression is common in rheumatologic practice, yet systems for identification, treatment, and referral of depressed patients are not universal. Rheumatologists' awareness of the need for mental health services is high, but they may lack the confidence, time, and/or referral networks to provide consistently effective care for depressed patients. Improving depression care in rheumatology may require a combination of clinician-level interventions (e.g., enhanced behavioral health training) and practice-level reforms (e.g., collaborative care).
KW - depression
KW - health care providers
KW - rheumatology
UR - http://www.scopus.com/inward/record.url?scp=84986182662&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84986182662&partnerID=8YFLogxK
U2 - 10.1097/RHU.0000000000000383
DO - 10.1097/RHU.0000000000000383
M3 - Article
C2 - 27556237
AN - SCOPUS:84986182662
VL - 22
SP - 307
EP - 311
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
SN - 1076-1608
IS - 6
ER -