Abstract P313: Feasibility of Nurse-Driven Identification of Depression in the Setting of Stroke at 30 Days Post Discharge

Abstract

Background: Poststroke depression (PSD) is under-recognized and affects the recovery and rehabilitation of stroke patients. PSD affects one-third of stroke survivors and there is little known when depressive symptoms manifest. Early identification of PSD may reduce its related functional impairment and mortality. Purpose: The purpose of this study is to demonstrate the feasibility of nursing driven depression identification at 30-45 days post discharge. Methods: All primary stroke patients received a phone call from SCRN to assess depression between 30 to 45 days post discharge using the Patient Health Questionnaire (PHQ9). Three attempts were made per patient. Data were analyzed from August 2019 thru March 2020. Based on the PHQ9 scores, patients were referred to different clinical care pathways. Patients who scored 1-9 received lifestyle modification information, 10-19 were referred to depression care management (DCM), 20 and above were referred to psychiatry. The number of patients evaluated and the percentage of those who were referred to specific pathways were assessed. Results: 427 patients were discharged with a stroke diagnosis. 197 (46.1%) completed the PHQ9 assessment. 14 (7%) were ages 18 to 44 years, 65 (33%) were 45 to 64 years, and 118 (60%) were 65 years and above. 92 (47%) were female. 64% were Caucasian, 19% Asian, 13% Black, and 5% Other. 30% were Hispanic. 72% were ischemic, 19% ICH, and 9% SAH. 230 patients (53.9%) were not able to complete PHQ9. 88 (38%) were unavailable, and 120 patients (52%) were not able to participate due to stroke severity. 20 (10%) were referred to DCM and/or psychiatry. Conclusions: Nurse-driven 30-day PHQ9 assessment is feasible and identifies patients with depressive symptoms. The 30-45-day post-stroke timeframe may be reasonable to diagnose depression after an acute stroke.