UTILITY OF DEPRESSION SCREENING DURING TOBACCO CESSATION

Abstract

SESSION TITLE: Tobacco Cessation and Prevention SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Prior studies have shown a significant incidence of depression in individuals with nicotine dependence. The question remains whether coexisting depression influences outcomes in patients undergoing tobacco cessation. The Pulmonary Tobacco Cessation Program at Brooke Army Medical Center currently performs screening for depression in patients enrolled in the Tobacco Cessation Program. We will perform a retrospective chart review to determine whether the presence of depression affects the outcomes in the patients enrolled in our tobacco cessation program. METHODS: This study is a retrospective chart review of the Clinic Tobacco Cessation database and electronic health records to identify patients undergoing depression screening prior to and during the tobacco cessation process. Those patients undergoing depression screening using the PHQ-2 and PHQ-9 screening tool will be evaluated for a positive or negative screen on PHQ-2 and if positive the PHQ-9 score will be recorded. We will review the electronic health records of up to 500 individuals to identify the results of depression screening, pharmacologic therapy choices for tobacco cessation, medication adverse effects and tolerance, number of sessions attended, and tobacco cessation rates at 4 weeks, 12 weeks, 6 months, and 12 months. RESULTS: An initial cohort of records reviewed found that 12 of 36 (33%) of individuals enrolled in the tobacco cessation program had a positive PHQ2 screen for depression. The subjects with a positive PHQ2 screen completed a PHQ9 screen and the mean score was 12.08 (range 3 - 23). Tobacco cessation rates for subjects with a positive screen for depression were 8.3% at 1 month, 0% at 3 months, 0% at 6 months and 8.3% at 12 months. Tobacco cessation rates in subjects with a negative screen for depression were 25% at 1 month, 25% at 3 months, 12.5% at 6 months, and 12.5% at 12 months. There was no difference in program completion rates among the two groups as defined as > 50% class attendance with 91.6% of both groups completing the program. In the group with a negative depression screen, 54.2% received varenicline, 33.3% received bupropion, 16.6% received nicotine replacement therapy, and 8.3% received no pharmacologic treatment. In the group with a positive depression screen, 58.3% received varenicline, 8.3% received bupropion, 25% received nicotine replacement therapy, and 8.3% received no pharmacologic treatment. CONCLUSIONS: The course completion rate defined by attending more than half of scheduled classes did not differ between patients with and without a positive screen for depression. Patient's with a negative depression screen were more likely to be abstinent from tobacco use at 1 month, 3 months, 6 months, and 9 months. CLINICAL IMPLICATIONS: Screening for depression with a simple screening tool may help predict success during attempts at tobacco cessation. DISCLOSURES: No relevant relationships by Deborah Bray, source=Web Response No relevant relationships by Jackie Hayes, source=Web Response No relevant relationships by Chinyere Mbagwu, source=Web Response No relevant relationships by John Untisz, source=Web Response