Abstract
IntroductionPatients with coronary artery disease (CAD) and depressive symptoms have twice the rate of mortality compared to cardiac patients without depressive symptoms. We assessed the hypothesis that disparities exist in the use and management of depression screening for patients in the ambulatory setting with CAD.MethodsWe performed a retrospective chart review of all patients at an ambulatory clinic from 2015 through 2018. We included all patients with documented CAD seen for primary care visits. Positive screening was defined as a PHQ2 score of 3 or greater, or PHQ9 score of 10 or greater. To assess demographic disparities, chi-square testing was performed.Results355 patients met criteria for inclusion. Of these, 201 were screened at least once from 2015 to 2018 (56.6%). Screening results are summarized in Table 1 and Figure 1. Males were screened less than females (52.4% vs 62.4%, p .061). Forty one of the 201 screened patients had elevated PHQ scores (20.4%), which were discussed in the treatment plans of 22 of these 41 patients (53.7%). White patients were screened less than non-white patients (49.7% vs 65.7%, p .0036), though white patients with positive screens were more likely to receive mention of the screen in their treatment plan when compared to non-white patients (72.7% vs 42.9%, p .01).ConclusionsWe found a trend toward disparity in depression screening by gender, as well as statistically significant disparity in screening and management by race. In conclusion, as patients with depressive symptoms and CAD have doubled mortality, depression screening and follow up may represent a critical opportunity to decrease outcomes disparities in heart disease.