Inpatient Depression Screening for Patients After Kidney Transplantation

Introduction: Depression in patients after kidney transplantation (KT) is documented in the literature to be between 20-60%. This has been associated with non-adherence, increased transplant specific morbidities and mortality, and significant negative outcomes such as graft loss and patient death. There is limited research on the prevalence of depression, and associated risk factors. The literature recommends routine screening of these patients, but that it rarely is put into practice. Research Question: Does implementing a process improvement intervention to screen inpatient admissions for depression increase early recognition of depressive symptoms in patients after KT? Design: A retrospective chart review evaluated the baseline for the current evaluation of depression in this setting during the 30-day period prior to study intervention. For the study intervention, 13 participants were included. The PHQ-2 and PHQ-9 screening tools were used to assess depressive symptoms when patients were admitted to a transplant unit, over a 30-day period. Results: Of the 24 patients included in the retrospective chart review, 62.5% of patient’s chart showed no evidence of evaluation for of depression. The exact Chi- square test was used to analyze the PHQ-2 scores, comparing those with PHQ-2 scores of zero with those PHQ-2 scores greater than zero. The following factors were found to be trending towards statistical significance: age, employment status, a rejection episode and living habitation status. Discussion: While the screening tool intervention did not identify any positive PHQ-2 scores, it does provide a feasible way to improve evaluation of depressive symptoms in patients after KT.