Session Information
Date: Sunday, November 8, 2015
Title: Health Services Research Poster I: Diagnosis, Management and Treatment Strategies
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Depression in patients with rheumatic disorders contributes to morbidity, mortality, and health care utilization. We set out to examine rheumatologists’ approaches to and perceptions of depression in everyday practice.
Methods:
A questionnaire was mailed to 470 practicing rheumatologists in California; 226 (55%of eligible respondents, after removing those returned to sender and who reported they were not in active clinical practice) were included in the final analyses. Respondents provided information on demographics, practice characteristics, attitudes towards mental health, and practices related to depression. Logistic regression models were constructed to assess the relationship of rheumatologists’ personal and practice characteristics with their usual depression-related practices (medication management, referral to primary care, and referral to psychiatry).
Results:
Among responding rheumatologists, 51% reported that at least half their patients suffered from depression, many of them untreated. Nearly all providers (99%) reported addressing mental health issues during at least some visits. When these issues were raised, it was usually the physician who initiated the discussion (69%); only 9% reported regular use of a formal screening tool. Rheumatologists were equally likely to prescribe antidepressants, refer to a psychiatrist, or return the patient to the primary care physician; about 60% reported applying each of the 3 strategies to at least half of their patients. In logistic regression models, greater number of visits per week and greater percentage of patients with fibromyalgia were associated with more prescription of antidepressants (p<.05).
Conclusion:
Our findings point towards a gap in care provision. Rheumatologists see a great need for mental health services but too often lack the skills and time to address mental health issues.
To cite this abstract in AMA style:
Heiman E, Wise B, Kravitz RL. Rheumatologists’ Approaches to Diagnosis and Treatment of Depression [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/rheumatologists-approaches-to-diagnosis-and-treatment-of-depression/. Accessed .« Back to ACR/ARHP Annual Meeting 2015
ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatologists-approaches-to-diagnosis-and-treatment-of-depression/