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Full-Text Articles in Medicine and Health Sciences

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski Aug 2018

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski

DNP Scholarly Projects

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if …


Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning May 2018

Family Nurse Practitioner Student Competencies In Integrated Psychiatric Healthcare, Mark Manning

Doctor of Nursing Practice Final Manuscripts

Title: Practicum to Practice: Family Nurse Practitioner Student Competencies in Integrated Psychiatric Mental Healthcare.

Background: Major Depressive Disorder (MDD) is a widespread and costly diagnosis that affects nearly 16 million people annually and costs the United States nearly $83 Billion. Primary care providers such as Family Nurse Practitioners (FNP) play a crucial role in screening for health problems, preventing, and managing illness. Opportunities exist to integrate psychiatric mental healthcare into FNP curriculum and clinical practicums to better prepare providers to identify and screen for depression.

Purpose: The purpose of this evidenced-based practice project is to evaluate FNP student competencies …


Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott May 2018

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

DNP Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …


Depression Screening And Care Management In Diabetes Patients At Rural Health Clinics In Primary Care: Quality Improvement, Marcy Doyle Jan 2018

Depression Screening And Care Management In Diabetes Patients At Rural Health Clinics In Primary Care: Quality Improvement, Marcy Doyle

DNP Scholarly Projects

Depression is one of the leading causes of disease and disability, often found in patients with long-term chronic physical conditions such as diabetes. Collaborative care, which includes care managers, has shown to improve depression outcomes in patients; usual care has been shown to be inadequate. This quality improvement project screened patients with diabetes for depression. Patients with an elevated depression screening score were provided care management support and rescreened every two weeks to evaluate depression symptoms. A small cohort of patients from two rural health clinics participated in the improvement project. The practices noted improvement in depression screening; patients who …


Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton Jan 2018

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …


Implementation Of A Depression Screening Tool For Cardiovascular Patients In The Primary Care Setting, Amber Nicole Ballentine Jan 2018

Implementation Of A Depression Screening Tool For Cardiovascular Patients In The Primary Care Setting, Amber Nicole Ballentine

Theses and Dissertations

Background: Patients with cardiovascular disease (CVD) have a two-fold increased risk of depression as compared to patients without CVD. According to the American Heart Association (AHA, 2016), there is no gold-standard procedure for screening for depression in cardiovascular patients. Screening for depression varies greatly across specialties and practices, often leaving a gap for detection and treatment of depression in cardiac patients. There are many depression screening tools available; however, the AHA recommends use of the patient health questionnaire (PHQ) screening tool. The PHQ-2 and PHQ-9 questionnaires are the most brief, sensitive, and specific depression screening tool for patients with …