Implement depression screening using a validated instrument for people with Parkinson’s (PWP) as part of standard of care in the specialist movement disorders setting and evaluate feasibility.

The Parkinson’s Foundation’s (PF) Parkinson’s Outcomes Project study found that a substantial proportion of PWP treated at select PF Centers of Excellence (COE) have depressed mood and don’t receive mental health services. Variability in depression screening suggests an opportunity to improve clinical care.

At five PF COEs depression screening, diagnosis and treatment practices were evaluated through retrospective medical record reviews at each site. The 15-item Geriatric Depression Scale (GDS-15) was used to systematically screen for depression. A depression factsheet, a treatment algorithm, and a depression-specific shared decision-making tool were shared with sites. Qualitative interviews with select clinicians and study participants from each site were conducted to understand the site’s standard practice and experience implementing the GDS-15. PWP’s who screened positive for depression (GDS-15 >4) were invited to be followed for 12 months to collect quality-of-life measures and details of depression treatment.

Over the year prior to depression screening implementation, site screening rates for depression ranged from 56-92%, but on average only 14% (range 0-57%) of screening across the 5 sites used a validated screening instrument. During the implementation phase formal screening rates, all done with the GDS-15, averaged 68% (range 54-84%) across the 5 sites. 378/1036 PWP screened positive. Among 137 screen positive patients followed prospectively, 15 initiated new depression treatment, while 72 participants maintained ongoing treatment. Data collection for follow-up visits are ongoing. 

Implementation of systematic screening using the GDS-15 is feasible although difficult to achieve at high rates. Ongoing follow up will examine changes in quality of life and symptoms of depression.