ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 006

Increasing Rates of Standardized Depression Screening in Youth with Systemic Lupus Erythematosus in a Pediatric Rheumatology Clinic

Victoria Newsome 1, Jodi Dingle 2, Manda Mitchell 3, Thomas Brent Graham 4 and Alaina Davis5, 1Nashville, 2Vanderbilt University Medical Center, Nashville, Tennessee, 3Nashville, Tennessee, 4Vanderbilt University Medical Center, Nashville, 5Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee

Meeting: 2020 Pediatric Rheumatology Symposium

Keywords: depression, Lupus, quality improvement

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

The 2020 Pediatric Rheumatology Symposium, originally scheduled for April 29 – May 2, was postponed due to COVID-19; therefore, abstracts were not presented as scheduled.

Date: Friday, May 1, 2020

Title: Plenary Abstracts Session 2

Session Type: Plenary Session II

Session Time: 2:30PM-3:00PM

Background/Purpose: Depression is common among youth with SLE.  Early identification and treatment of depression has the potential to improve health outcomes for youth with SLE.  Pediatric rheumatologists are uniquely positioned to provide depression screening and intervention due to the frequency of patient encounters and ongoing therapeutic relationship with patients and families.  The aim of this quality improvement project is to increase rates of standardized depression screening for patients with SLE presenting for follow-up appointments in our pediatric rheumatology clinic from 0% to 90% by July 1, 2020.

Methods: All patients with SLE (defined using specified ICD-10 codes) who are ≥ 12 years of age and seen for follow-up in our pediatric rheumatology clinic are included in the project. The Pediatric Health Questionnaire-9 (PHQ-9), a depression screen validated in both a general adolescent population and in patients with SLE, is administered via electronic tablet during the patient encounter and immediately uploaded to the EHR.  Screens are automatically scored with treatment plans suggested for the provider based on severity of depression symptoms using the PHQ-9 standardized scoring and treatment algorithm.  A multidisciplinary pediatric rheumatology clinic team (including resident, fellow, attending, social worker, case manager, nurse, and front desk staff) developed a key driver diagram to anchor potential project interventions (Figure 1).  The team meets on a biweekly basis to plan and evaluate interventions using the structure of plan-do-study-act (PDSA) cycles.  Statistical process control methods are used for data analysis.

Results: The percentage of eligible patient encounters where depression screening was offered increased from 0% to 60.8% following implementation of the electronic PHQ-9 on September 16, 2019. This represents special cause variation as evidenced by a data shift (eight points above the mean line) on the control chart (Figure 2).  Additional PDSA cycles are annotated on the control chart, but there are insufficient data points at this time to determine subsequent special cause.  There were 9 encounters where the patient declined to complete the depression screen.  Of the 50 completed depression screens, 26 (52.0%) were positive – 15 (57.7%) with mild, 9 (34.6%) with moderate, and 2 (7.7%) with severe depression symptoms.  Suicidal ideation was identified in 5 patients.  Appropriate interventions were documented including social work involvement, home safety plan, and psychiatry referral.

Conclusion: Rates of depression screening for youth with SLE significantly increased upon implementation of electronic PHQ-9 administration integrated with the EHR.  Identification of patients with symptoms of depression and/or active suicidal ideation facilitated development of interventions that otherwise may not have been addressed during the patient encounter.Future PDSA cycles will focus on refining the current process of depression screening and incorporating insights from patients and families.

Figure 1: Key Driver Diagram outlining project aims and interventions to date.

Figure 2: Control Chart with annotated PDSA cycles demonstrating special cause variation with increased rates of depression screening from 0% to 60.8%.


Disclosure: V. Newsome, None; J. Dingle, None; M. Mitchell, None; T. Graham, None; A. Davis, None.

To cite this abstract in AMA style:

Newsome V, Dingle J, Mitchell M, Graham T, Davis A. Increasing Rates of Standardized Depression Screening in Youth with Systemic Lupus Erythematosus in a Pediatric Rheumatology Clinic [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 4). https://acrabstracts.org/abstract/increasing-rates-of-standardized-depression-screening-in-youth-with-systemic-lupus-erythematosus-in-a-pediatric-rheumatology-clinic/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2020 Pediatric Rheumatology Symposium

ACR Meeting Abstracts - https://acrabstracts.org/abstract/increasing-rates-of-standardized-depression-screening-in-youth-with-systemic-lupus-erythematosus-in-a-pediatric-rheumatology-clinic/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology