In an editorial that appeared online in the Annals of Internal Medicine, Dr. John W. Williams Jr. of the Durham (N.C.) Veterans Affairs Medical Center and Dr. Gary Maslow of Duke University, also in Durham, advised generalist physicians to “seize the day and act to implement these guidelines” (Ann Intern Med. 2016 Feb 8. doi: 10.7326/M16-0104). “Implementing high-quality depression care is not easy, but trials and demonstration projects show that it is possible and rewarding.”
Dr. Williams and Dr. Maslow went on to suggest ways that clinicians might incorporate the guidelines into their own practices. “For practices initiating screening for the first time, a pragmatic strategy might be to screen in conjunction with routine health visits and target persons with symptoms associated with depression (for example, insomnia) or risk factors, which in adolescents include female sex, older age, family history of depression, other mental health or behavioral problems, chronic medical illness, and overweight or obesity,” they wrote. “For practices with electronic health records, clinical reminders can be used to prompt staff to distribute screening questionnaires or verbally administer questions along with assessment of vital signs. The Guidelines for Adolescent Depression in Primary Care toolkit includes screening measures, screening procedures, and patient education materials to support the screening and treatment.”
The way Dr. Krist sees it, the overall message of the new recommendations is simple: Screening adolescents for depression has benefits. “We want primary care clinicians to do this, and we want to make sure that primary care practices put systems in place to care for adolescents with identified needs,” he said.
The Agency for Healthcare Research and Quality funded the review that formed the basis of the recommendations. The authors of the recommendation statement reported having no relevant financial disclosures.