The feasibility of a GP led screening intervention for depression among nursing home residents

Abstract

To examine the feasibility of a brief intervention training general practitioners (GPs) in the administration of a depression screening instrument for use among nursing home residents. GPs attended a single education session on late-life depression and were trained in the use of the Cornell Scale for Depression in Dementia. Following the intervention GPs reviewed their patients for depression. Diagnosis of depression pre and post intervention; changes in antidepressant medications post intervention. Ten GPs and 38 patients completed all components of the study. GPs identified that 24% of their patients had Cornell Scores indicative of probable major depression that was either unrecognised or inadequately treated. 88% of these patients had been previously diagnosed with depression. A further 32% of patients exhibited depression symptoms, half (50%) of whom had a previous diagnosis of depression. Reviewing patients had an effect on antidepressant prescribing for patients with probable major depression, with GPs making changes to the antidepressant medication of 29% of patients. The high rate of residents presenting with probable major depression despite being prescribed antidepressants indicate that depression symptoms are inadequately recognised and treated in nursing homes. This study demonstrated that a single education session on late-life depression was feasible and was associated with an improvement in GPs' recognition of depression among nursing home patients.