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Fahd Naufal, Prateek Gajwani, Madison Dutson, Robert Medina, Bonnielin K Swenor, Silvio Mariotti, Sheila K West; Knowledge of Mental Health Status and its Impact on Clinical Care of Ophthalmology Patients.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3080.
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This study aims to determine if and how ophthalmologists use anxiety and depression scores to determine clinical care of patients with chronic eye disease.
Patient older than 18 years of age presenting to ten providers at Wilmer Eye Institute’s Glaucoma and Retina divisions were recruited, consented to participate and enrolled in this study between April and June of 2019. Two internationally validated screening questionnaires were selected to acquire data on emotional well-being: The Patient Health Questionnaire (PHQ-9) for depression and the Generalized Anxiety Disorder (GAD-7) tool for anxiety symptoms. PHQ-9 scores above 5, 10, and 20 are classified as mild, moderate, and severe depression, respectively. GAD-7 scores above 6, 11 and 16 are classified as mild, moderate and severe anxiety, respectively. Scores from these instruments were provided to the ophthalmologists just prior to the clinic visit.Following the clinical appointment, physicians were queried to determine whether knowledge of these scores impacted their clinical approach, communication style, treatment plan and follow-up protocol.
A total of 100 patients were enrolled (average age of 63 years) in this study, of which 54% were female, 18% reported mild to moderate anxiety, 17% reported mild to moderate depression, 6% reported mild to moderate symptoms of both, and 2% reported severe suicidal ideation.The ophthalmologist response to patients with mild or greater severity of either depression or anxiety was to change clinical approach (27.6%) and communication style (31%). Reported change to clinical approach (40%) and communication style (80%) were greatly increased in those with severe depression or anxiety. Change in communication style was in the form of spending more time listening to the patient (41.7%) or giving more information to the patient during the clinic visit (33.3%).None of the physicians reported a change in choice of treatment or modified follow-up protocol, but referral to social work/psychiatry services was 13.8%. Two participants with high depression and anxiety scores were not referred to further health services as they were already under treatment.
Knowledge of the mental health status of ophthalmology patients may change the clinical approach taken by ophthalmologists during clinic visits.
This is a 2020 ARVO Annual Meeting abstract.
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