Department of Neurology VA HSR&D Center on Implementing Evidence-based Practice Regenstrief Institute, Inc. IU Center for Aging Research
Implementing Evidence in Post-stroke Depression
Dr. Williams led an implementation study to evaluate the effectiveness of extending the existing primary-care based annual depression screening tool to screen veterans for post-stroke depression. The team built electronic reminders for screening and, if screening was positive, for treatment. The reminders prompted best practice and recorded processes of care. The intervention was implemented at two VA medical centers. Compared to the year pre-implementation, the intervention significantly increased depression screening in the first six months post-stroke (odds of screening 4.8, p < 0.001), and depression treatment (odds of treatment if screened positive 2.5, p 0.05). This study demonstrated that automated depression screening in primary and specialty care can improve detection and treatment of depression post-stroke. The reminders remain in use at multiple VA hospitals. (Williams LS, Ofner S, Yu Z, Beyth RJ, Plue L, Damush T. J Gen Intern Med 2011;26:852-7.