Abstract
Purpose: The purpose of this quality improvement project is to evaluate patient outcomes from a clinic providing ketamine infusions for treatment resistance depression.|Background: Treatment resistant depression is a difficult disease to treat. It is reported that up to 30 % of patients with a major mood disorder do not respond after attempting four different medication trials (Rush et al., 2006). Few treatment plans are available except attempting different medications, increasing the dose of medications, or consideration of electroconvulsive therapy. Low dose ketamine infusions have proven to rapidly relieve symptoms of depression when other therapies have failed.|Sample/Setting: The setting was a newly developed clinic (Advanced Infusion and Wellness Center, LLC.) owned and operated by APRNs in Wichita, KS. A total of 28 patients participated in the quality improvement project. Patients age ranged from 20-72 years of age with a confirmed diagnosis of treatment resistant depression.|Methods: This quality improvement project evaluated outcomes during and after six initial ketamine infusions that were given 48 hours apart. PHQ-9 scores were collected prior to infusions and 24 hours after each infusion. Becks Depression Inventory scores were also gathered prior to infusions and 24 hours after the sixth infusions. Statistical analysis was conducted to compare clinic outcomes with evidence-based research results.|Results: a statistically significant decrease in the Beck’s Depression Inventory was noted from baseline to after the 6th infusion, t(16) = 6.65, p < 0.001. The repeated-measures ANOVA analysis also detected a statistically significant main effect across time for the PHQ9 survey outcome, F(6,150) = 38.52, p < 0.001, η2 = 0.61, power = 1.0. Post hoc testing found significant decreases in PHQ9 scores from baseline to all 6 infusions (baseline to after infusion number 2, p < 0.001, baseline to after infusions 3, 4, 5, and after the 6th infusion, p < 0.001). There were not significant decreases after infusion 3 to after infusion 4, (p = 0.28), or between after infusion 5 to after infusion 6 (p = 0.18).|Conclusion: Ketamine infusions are an effective therapeutic modality for patients with treatment resistant depression. Successful outcomes were comparable with results demonstrated in the current literature.